Maintaining Wellness and Creating Clarity during Crisis

Will We See a Post Traumatic Pandemic Syndrome?

In a time with so much uncertainty, sickness and death how do we continue to maintain a positive outlook? What are the best ways to share em- pathy and create harmony in our homes and in our neighborhoods once things return to a semblance of ‘normal’? This week we look at several therapeutic approaches to these and other prescient questions with mental health thought leaders working on the front lines. We encourage first responders and medical professionals to participate in this most Profound Conversation. Profound Conversations is a moderated discussion with a question and answer segment for listeners to contribute thoughts and seek guidance.

Show Topics and Highlights

Will we see a post traumatic pandemic syndrome?

“We are experiencing financial challenges, health challenges, we have fears about today, and we have fears about tomorrow. And many of our families are in crisis.”

We have this innate sense of helplessness and hopelessness that starts seeping into our own personal lives. 

“What have you been seeing in terms of what some of the first responders has been have been experiencing?”

“When we use the word mental health, that it kind of seen as a red flag for most people, something to be stigmatized. So we can hide it and say Behavioral Medicine or behavioral health . . . .  We are not talking mental illness, we are talking mental health and wellness.”

We rarely go to the underlying disease, which is the social, economic, cultural disparities, the inequalities that are still very prevalent in the country.

Hugging is a warm exercise in compassion. . . everybody will literally need a hug.

What kind of advice do we have for nurses and other first responders who are struggling with the life and death challenges on the front lines?

Profound Conversations Executive Producers are the Muslim Life Planning Institute, a national community building organization whose mission is to establish pathways to lifelong learning and healthy communities at the local, national and global level.   MLPN.life

The Profound Conversations podcast is produced by Erika Christie www.ErikaChristie.com

Full Transcript

Linda Howard

All right. Good afternoon, everyone where our panelists are getting logged in. Erika, do you would you like to get started with some of the technical stuff while we're waiting?

Erika Christie

Hello, everybody, thank you so much for watching. Yes, the two big things, if you guys would like to be chatting, as we're talking, there's a chat feature up at the top of your screen. And that chat goes amongst yourselves. So if you guys, you know, really like a point want clarification on anything. Go ahead, and, you know, go into that chat feature. Also, across the top of the screen, there's a Q&A. So if you have any questions for the panelists, either during the webinar or for the Q&A section at the end. And just go ahead and let us know what your question is. If we've got enough time at the end, we also might go live for a couple If they would like to ask questions as well, so, all right, back to you, Linda. Okay.

Linda Howard

Welcome to Profound Conversations. The day's topic is maintaining clarity and wellness during crisis. And the question that we're going to be asking today is will we see a post traumatic pandemic syndrome? profound, profound conversation is a listening and discussion space, which brings thought leaders into conversation for them to grapple with challenges of our time. Our goal with profound conversation is to use intercultural dialogue, and community in organizational engagement engagement to achieve valuable cultural education, Economic and Policy outcomes. Now, today is our third episode. So we're very proud to have gone three weeks in a row. with profound conversations, we got very positive feedback from the first two, and I'm trusting that this this one is also going to be engaging. Our first episode was around managing mental health and wellness during turbulent times. The real wealth is good health, kindness and compassion. I know some of you may have attended that. That session. And at the end of that session, I raised the question about whether or not we will see post traumatic and pandemic syndrome. And my guess is that we will, but we have two mental health professionals that's going to be with us today that can better answer that question for you. So I'm going to defer to them and, and Dr. bossy actually had some practice. He was our speaker for our first professional conversation, and I gave her a heads up that when we invite her back, we'll be asking her to address that issue. So Dr. bossy I hope you are ready. We will have with us Latif Rasheed. And we're very excited to have him as well because we wanted to have them for the first session, but he was not available. So we have the opportunity to bring Dr. Abassi and Latif Rasheed together for this for this conversation. And we're, you know, we think this is a really, really important conversation and an important time to be having this conversation, because we are in some very uncertain times. We are experiencing financial challenges, health challenges, we have fears about today, and we have fears about tomorrow. And many of our families are in crisis. As you know, some of the unresolved issues start to bubble to the top. Now that we're in this crisis. As Dr. buss he told us two weeks ago Domestic Violence is on the rise. And we know that our first responders are healthcare professionals are seeing a lot of pain and suffering. They're watching people die without the presence of the family being able to be there because the hospitals are on lockdown and not allowing families to come into the rooms. We also there those healthcare professionals are having to make some unimaginable choices around who lives and who dies, sometimes is very little guidance around the standards around the standards of care. So today, our conversation, we hope to get some understanding from our from our professional conversationalist around some of the best ways for us to share empathy for us to maintain our own personal wellness and clarity in these times. And how do we prepare for what Muslim life planning Institute has made? The post pandemic post traumatic pandemic syndrome that we believe that many of us will experience. So we're going to jump in. And I'm going to ask Dr. Abassi. To give us her thoughts on what she thinks about that whether or not we will see some of this post traumatic pandemic syndrome.

Dr Farha Abbasi

Thank you so much for having me back again, and continuing this important conversation. So last time, I was doing more like projection and anticipation that that's what we are going to see. But today we have the grim reality, the domestic violence numbers have gone up in the whole world. If you see the New York Times just didn't whole article about it, to the point that the UN is bringing attention to it. And making it mandatory to take care of this as a urgent crisis. So that said and done, we could trace it back and talk to you about what is happening. Is it like pandemic induced trauma, or trauma, on trauma, like if you had some previous crisis or previously, if you were being abused, is this isolation is a very scary thing, because in isolation, the perpetrator becomes empowered, and the victim becomes more helpless. So isolation is a tool used by far by perpetrators domestic violence abusers. So now that we have this mandatory isolation in place, we are seeing both sides of it. So there are cases which already were, you know, identified, right? risk that how do you support and protect those spouses or intimate relationships where we there is a history. But then there is the situation like you said, we are dealing with complex stress, anxiety and trauma right now. So it could be financial, it could be health, it could be being away from loved ones or being too close to family members that you don't get along with. It could be academic, it could be so much layers to this problem. Another thing that we are seeing is normally what happens that the loss happens and you are grieving. And that then starts your grief process, and then comes healing Right. Right now it's like this trauma is extending. It's like an anticipatory grief. We are getting this every day bit by bit bit by bit. So You brought a very important point and I want to correlate both the situations. So those of us who are in forefront of it, like when we see numbers, like we just had a psychiatrists casualty first psychiatrist to die do to go with 19 virus, but we have like 700 people in Detroit mental sorry, health workers COVID-19 positive our numbers are going up, or you see resident that so you see physicians, nurses, bus drivers, police force, everybody is getting affected and impacted by it. So what happens is what we call is compassionate fatigue. compassionate fatigue happens when you get exposed to this persistent trauma. Signs of compassionate fatigue can be just physically mental exhaustion, irritability, anger, frustration,

guilt, having more negative thoughts, difficulty going to work feeling overwhelmed and then when you see people dying, like you said, people dying and not able to be see their families or loved ones, that gives you a guilt, like survival guilt, or the guilt diet because we, as providers, forget that we are bearers of pain, we bear the pain with our patients, but we cannot totally we are not in control of the outcome. So it's a really nice book that says, we can be God players like after god yes, we are in forefront we are dealing with life and death, but we are not God. So the ultimate outcome is not in our hand, but when we see people Be a caring for dying. We have this innate sense of helplessness and, and hopelessness that starts seeping into our own personal lives. So if we do not become cognizant of this do not take care of it, it starts to seep into our personal lives. It can go into our professional lives, it can affect us individually affect our relationships affect so much society around us. That compassionate fatigue leads to burnout. We have high burned out rates, but another phenomena that happens is vicarious trauma. That is trauma by association, or secondary trauma which does present as PTSD. So you will get seen things like you can have no nightmares. You will have flashbacks. You will avoid situations you will become overwhelmed easily you are hyper alert. So this is this is what is gonna need to what you are referring to is post pandemic traumatic stress disorder. But what happens with vicarious trauma, it is hard for you to continue to perform your duty to live happily or to continue healthy relationships. So one sign can be high levels of irritability, anger and frustration, which again, makes sense for us to see an increase in intimate partner violence. So we are bringing bringing frustrations, anger, and it could be you could be in a health field right now you could be in like a police officer, firefighter, or anyone in forefront of it. Feeling all these symptoms Without taking a break without taking a internal assessment of where we are right now and unconsciously, there are consciously doing some abusers doing it consciously with intent but there could be an act of omission unconscious without intention, realizing that we are bringing all that stress home and taking it out on the vulnerable around us. That could be spouse, that could be kids or that could be animals.

Linda Howard

Latif joined us so I will ask I'm going to get you right in here, Latif. And Latif works with a lot. He works with first responders so he is the psychotherapy with the help me out here . . . . fire department and and ESM. Which county is that?

Latif Rasheed

Yeah, Maryland in Prince George's County.

Linda Howard

Okay, so, um, Latif, we're talking about just some of the some of the trauma that people are experiencing now and also what they may experienced post this pandemic and I know in your work or working with first responders, they're out there on the front line right now. So what have you What have you been seeing in terms of what some of the first responders has been have been experiencing?

Latif Rasheed

Well, I think overall,

not just first responders, but people are pretty much resilient. I mean, they're having symptomology now as this as the doctor does reference, but I think most of us gonna come. Skype the proverbial waiting for the other shoe to drop. I think in the aftermath, that's when we'll see a spiking a real spiking in terms of Symptoms in terms of mental health issues right now. Those are pretty much I think pretty much contained people are certain have cabin fever. I mean, I'm talking about people in general. And that

whether that's first responders or

Linda Howard

which is a police by corrections, military, I think they're all pretty much doing a pretty brave job given the situation. But the time we should be much more wary of we're young, is it after the cessation quote, unquote, cessation of the trauma and the pandemic? And so, yeah, pretty much but the other thing is that person's . . . .

I think we're having a little bit of technical issues here now we know that everyone's home using the internet. So this is a little bit more challenge in terms of in terms of the connectivity. So, Dr. Dr. Abassi let me let me ask you this while we're waiting for Latif to to reconnect Have you had patients who are first responders who are healthcare professionals that you've actually done some one on one work with?

Dr Farha Abbasi

Um, so so far no, I'm because I'm basically right now working at a Jarrow psych unit at McLaren hospital and also through Michigan State University doing my outpatient clinic But we just started we have just started to compile a test force mental health test force under Mayor of Lansing office. And we intend to bring all the all these different services together to assess the trauma, the need and to see how we can share resources and come up with a plan that kind of be proactive to the anticipatory pandemic of mental illnesses that people see.

Linda Howard

Latif we lost you for a moment.

Latif Rasheed

Oh, okay. Where did I get lost?

Linda Howard

(laughing)

Latif Rasheed

I'm lost but now I'm found.

Linda Howard

So, um, is there there any recommendations that you have for for, for the listeners today that people some steps that people can start to take to look at protecting their mental well being and to help them possibly avoid that impact that we say is possibly going to come and that's that post traumatic syndrome?

Latif Rasheed

Well, I think first of all is the is verbiage language. I think the when we use the expression mental health, it's, besides it being quote unquote, stigmatizing that it puts people more so in an alarm state. So we're really looking at behavioral health, how are they behaving in the context of what's going on? So looking at the behaviors and when we look at behaviors, we're not looking at quote unquote therapy rising people at this juncture that may come later on if the need if need be. But right now we're looking at just the making sure people have their regular needs people are tethered or anchored or grounded to just being able to do some regular things. The most important and most important things is getting sleep and saying, so, how are people sleeping? That's that's one of the primary things people want to know.

Are they having early awakenings? Are they having

delayed onset of sleep? I mean, those kinds of things we can address initially. Besides sleep, are they having any physiological issues like gustatory issues, they haven't problems eating, or are they having problems, eliminating Problems eating problems and eliminating those are purely peculiarly of concern at this juncture. So I would start in that regard in the mean, are they using substances? Whether or not it's not about hold on hold on? I mean, it is, but it's not. I mean, in terms of the context, are they using substances that may have had been free of substance use, I mean, alcohol drugs or whatever, some time ago, but this onset of not knowing how to respond to the stimulus or distress of the situation, may take them back to using illicit drugs or alcohol. So we want to address those kind of issues right now to try to see okay, well, how can they move from an a clinical and maladaptive response to the issue towards an adaptive one? What can they do? adaptively so One of the things they can do adaptively is movement. I mean, everyone has heard about the fight, flight or freeze, but the when there's onset of a particular trauma or a threat or a scare of any sort, but in in that response, there's also embedded there in a, a remedy of sorts. People need to be moving. One of the things about trauma is the fact that people feel locked in locked down. They can't move. Movement is is therapeutically recommended people to move and I think that's what we see. And we might wonder why not everybody's standing staying at home, but some people just got to get out. I mean, while it may be against the recommendations of the CDC and the like, but people need to have movement when people have emotions, emotion, I read somewhere, it comes from a French word which means to get out or to move. Like, likewise, we need to have movement in the saying, and movement. It doesn't need to be a marathon race or bicycle chase or whatever like that. But it has to be mindfully engaging.

Dr Farha Abbasi

So just one thing. I do understand when we use the word mental health, that it kind of, kind of as a red flag for most people comes out with stigma. So we can hide it and say Behavioral Medicine or behavioral health, but I have a simple question for you. You say you are focusing on very like behaviors, right? appetite, sleep, but every behavior is controlled by a thought in your mind. So your behavior Emotion thought. So yes, I know you have to start superficial, but until unless you take it to the deep down what thought is triggering this behavior, we will not see right outcomes. So I do agree with the movement, but sometimes it's the mind that needs to be expanded. So, one way I look at it, maybe we can't use mental health, we can call it start we have the start we have started calling it behavioral health or wellness. We are talking wellness, wellness does not just come from physical health, the mental health and physical health both come together, right. So one thing I feel is very important, this is a can be a very teachable moment for all of us, and a kind of unveiling of the stigma moment where we all have to come in embrace it and use this moment to talk as a as a whole person. The like you, you can't separate appetite from being sad. You can't separate sleep from being anxious. So until unless, like you said, You are not looking at paraphrasing, but I think it is very important to bring somebody to create those safe spaces. So one thing is physical movement, but you also need that emotional support centers. And, I mean, I personally think this is the moment where we can really bring it together and really go to what we are seeing the health disparities that how big inequalities is impacting this virus more right. And the health disparities How are they coming out not only in physical health elements, but also emotional health elements mental Health elements. So there is a difference. We are not talking mental illness, we are talking mental health and wellness.

Latif Rasheed

Right? I pretty much agree with you and my licensure, I'm a licensed mental health therapist. That's my license. I not be forthcoming, but and say when people hear mental health, they panic. So I'm trying to make myself more friendly. And I'm saying, me, behavioral therapists, you know, I mean, that's like, oh, okay, you know, that's more welcoming. I mean, right. I agree. But I do have a theory. I mean, it hasn't been. I mean, it's piecemeal from other disciplines. But I think a lot of the underlying conditions, I mean, personally, this should be universal healthcare, but that's a side point. But regarding underlying health conditions, particularly in certain populations within America and we know who they are. I send I tend to treat Trace those back to,

you know,

historical and genetic issues in America. When people speak in code words, we're not talking about the history of enslavement. I mean, of the decimation of their culture of their language. And I mean, those things would be traumatizing to most people

Dr Farha Abbasi

And intergenerational trauma,

Unknown Speaker

The historical impact of that has not been quieted has not been put to rest and saying that still lives alive. So manufac some of the one is one primary premier therapist Bessel Dr. Van der Kolk. Yeah. talks about the loss of the instinct of purpose. Right or severely traumatize can lose the instinct the purpose. So when we look at people, be rift of direction, the Rift, meaning in their lives, and it's more than just an occasional thing amongst a certain population. It has prevalence. You have to start wondering as the are these people just as the assertion is shifty and shifty and lazy? Or has something really happened to them to under to undermined or undergird they're being humane or human.

Dr Farha Abbasi

you know, the trauma informed care is you'd never say what is wrong with you, but what wrong happened to you?

Latif Rasheed

Right. That does

but that but even acknowledging that in terms of what's happened to us, this note is no no coincidence that there is a significant they may hypertension, I pretension myself and I mean, and some of this, some of the traumas as we know we can speak about But there are traumas there are unknown traumas that people have lost MOS cognition of there's something wrong, they know it's happened but they can be they have no language for it. It happened and happened maybe pre pre birth and then they have some sort. So these historical trauma the store stalker wrongs are registered in terms of kidney tissues, liver disorders and spleen disorders that are that are legion in the African American and Latino communities and Native American communities for sure. suicidality, homosexuality. alcoholism, so right to Asians are reflective are the offspring of the traumatization of the discrimination of the oppression and

repression that they've suffered?

Dr Farha Abbasi

Right. And that's why I feel this is the moment Vivi for the longest and this country have dealt with bandits. So solutions. We try and go with the symptom. We never go to the underlying disease, which is the social, economic, cultural disparities, the inequalities that are still very prevalent in the country. And now this pandemic is showing us the outcome of that. But that's why I think it is important when we talk of trauma you talk about so we know the study of adverse childhood experience, which actually, I just found out, none of their subjects were from a minority race or any colored people, people of color, sorry, people of color were included in that Adverse Childhood Experiences survey. But still, the survey says that those who have been traumatized their lifespan can be shortened by 10 to 14 years.

Latif Rasheed

That's right. And so both of them to predispose them to addiction Sam predisposing to hypertension. predisposing to domestic violence. I mean, it's an it's an amazing study. And those are the ace, Ace factors, adverse childhood experiences.

Linda Howard

Adverse childhood experiences because I would imagine that some of the attendees on the call have children. And this is an experience that children are also going through. I had a conversation with a friend of mine who said that his seven year old was having trouble coping. And the seven year old actually requested counseling because he had an understanding of what was happening also being separated from his friends and being in the house. So knowing what you know about, you know, that adverse childhood experiences, how do you think this whole experience is going to impact this younger generation is there anything that that some of the public parents or grandparents can do that maybe listening to this that could help the children.

Dr Farha Abbasi

That's validation, validation, validation. So, we definitely are gonna be, there is going to be a pre covered era and a post COVID COVID-19 era, we don't know what the world would look like, what the world is gonna look like for these children. I can just tell you one thing, that kids these days are so much smarter, they have so much information on their hand, they have so much exposure, that we have to step away from the fact that they are kids. They are they it's good right now to have this conversation and deal with them. As a person, irrespective of the age, I responded to a domestic violence call I was sitting with the kids, four and six years old. And the way those kids were talking to me and the way they responded like it wasn't a four year old, you you mature, you grow up when you face adversity, your your innocence and naivety is the first victim. So I think important thing is validating them, communicating with them, listening to them, assuring them and do whatever resources is needed to help them through this. I see most of parents come out with this. What's wrong? Why are you acting this way? You have these games, you have videos, you you can do this, you can do that you have so much. Look at other people. That is okay, but that's not the right response.

Latif Rasheed

Exactly.

Yeah. I think one of the things about trauma we need to think about or consider trauma is a rupture, oftentimes as an attachment rush rupture. So in terms of and, and the fact that those children that you spoke of a, have been using another expression on Delta FIDE, they speak like young adults. I mean, that is that's an on some, in some regards. People take pride in that my, my child is so much grown and not like a little kid or whatever. But we're looking at it in the wrong way Has something happened to make them so. Not children, you know, Has something happened? Are they imitating their environment? I think most of the kids will, will Well, I mean, because kids are like, copy machines. I mean, they can Unique behaviors around them. And that to the degree that the the adults are in the home, that they're regulating the atmosphere with calm or with with chaos, the children going to pick up on that they're going to feed in. So a bank, chaotic atmosphere, the main, we're going to quiet him down with a video game that's more than chaotic. And I'm saying that's not I don't know, I don't play video games. But in any case, neither do I.

That's a false comforter.

Unknown Speaker

So false comforting to think that we can we can put the bed or we can quiet them down with something that activates their you know, their cortisol in the main that release of cortisol in them, so they become hyperactive, not less agitated as irritated. So that's, that's unfortunate. But overall, I think that, you know, it really depends on how we are very attending. All kids need to have three have to have three things, a feeling of significant security and safety. And when they know that they are safe and safety is not just, you know the doors are locked to whatever safety is a visceral experience, it's from within feel safe. Do they feel threatened saying our i mean is there a is there the potential ality of abandonment, I'm saying because their parents can't parent them anymore for whatever reason them and say, oh, can't care for them sufficiently for whatever reason. Those are the things that like we really need to be on, watch for and pray and be prayerful that they don't impact our families, our our communities and the like, but the sense of community is important. community coming together, a sense of touch, embracing Vander kolk talks about the importance of big role contact I'm saying the importance of hugging, for instance, hugging is therapeutic well.

Dr Farha Abbasi

But if it's a safe environment, right,

Latif Rasheed

yeah, you would

But hugging is a is a

it's a warm exercise in compassion.

It's an expression of caring saying is this in and it gives a communication of you belong. This is a time when people don't feel belonging, people feel isolated and the like, not just kids, but also adults. Everybody would literally need a hug, no man, if that would be able for us to do that. But at this juncture, but nonetheless. So the sense of safety, security and significance, those are the things that our children need.

Dr Farha Abbasi

So building on that, and at Interesting thing that trauma does. So all this weakness, we don't have a finality to the situation. All this vagueness and predictability A lot of us are going like, especially being exposed to trauma, something happens which is called depersonalization. Yeah. You You can't absorb the reality. So you start disconnecting from the reality. And for the kids also, it must be so perplexing, confusing, like what is going on, suddenly, they can go out and play can't connect with their friends. They can't go to their grandparents. So it's a it's a moment of real confusion. So making it like, and some people become very protective that they shouldn't get exposed to news. Maybe not to television, but break. Let them know educate them. in your own way, and in like, Do share the facts with them. And do share your own anxiety also in a healthy way that yes, it's not only you, we all are feeling stress and we can all do something about it. Visibility, assurance valid at all this is very important.

Latif Rasheed

Right? All that's important and as much as possible to have a sense of routine. Structure and routine is structure structure is control. And while we don't have control of what's happening around us, can we control the household? Can we have a quiet time? I mean, I mean, there's excitement every there. Can we turn off the TV at a certain time during the day or evening or whatever? Can we sing some songs or reads, read some books or pray together and make dough together, meditate together.

Besides control of the environment is critical,

Dr Farha Abbasi

critical. So another very good point right now is control is not controlling,

Latif Rasheed

Control is not controlling. I love that.

Dr Farha Abbasi

it's like control is how the discipline structure is how the but if you try to control like you feel like I have to control everything that is not healthy, that's from physiology, how it becomes pathology, and controlling whenever you try to control another human being, that's the beginning of your abuse in some way, or farmers shape. So be aware of that.

Latif Rasheed

Right? When people are out of control, they become obsessed with controlling others in the mean, and controlling their environment. So that's right on exactly right on and people get really frustrated when they can't predict outcomes that can't predict their significant others behavior or their response. So that exacerbates the need to control to have control over others. But really, there's I'm out of control.

Linda Howard

So, those of you who that are attendees, we're going to open the line up in a little while for questions. So think about your questions, you can either type them in the chat and Erika of the chat is not for them if you could do that. Also, you could raise your hand and we can respond that way. But I do have. I have another question that so I'm going to start the questions out with this one is, you know, when we talk about kind of the full cycle of dealing with this dealing with this pandemic, one of the realities that some of us are facing is that we're going to lose people. And we're either going to lose people as a result of the pandemic, or we're going to lose people, just during this time of the pandemic. Now, no, and I'll share a personal story is that one of my closest friends had a heart attack a few days ago when she's on a respirator. And it's a really difficult period because one is the questions about how long will she be kept on the respirator? Second is family cannot go to see here. So even that normal of just trying to assess like, what do you do? Do you continue life not continue, like, you can't be connected? Thinking about, you can't visit the person, you know, the funerals are not possible that those are going to be you know, they're limiting them to 10. So all of the usual ways that you have in order to go through the grieving process have been taken away. And how does so this is I'm also asking from a personal standpoint, but but how how should we how what are some things that we could do to help us through that process when all of the normal things that we normally Do is not in place.

Dr Farha Abbasi

So it's like the fire started remotely and it's getting closer and closer. So all of us are feeling the intensity and heat of it. To me just reading about psych, a psychiatrist losing his life is getting closer to me, colleagues, family friends. So, unfortunately, even if we go over that Kubler Ross grieving process from denial avoidance, anger, bargaining and acceptance, we don't have the luxury right now. And it's again the finality is not there. So we are feeling an immediate loss. But we also don't know if it has ended for us. So you know, the Exposure to danger, stress. It's if it's limited, you know, okay, it's going to end. But right now, it's just so much vagueness around it. I think Still, the basic rules of self care has to apply, how much harder it is, the more the need to do it. Self Care means whatever your way of self care is, if helping talking to friends, family, I see a lot of this stories being shared on social media, which is even strangers putting like God bless your family or my heart is going up. We are kind of holding that kind of prayers and wishes it's self soothing. So keeping those connections, talking to people you care or talking to again, Using therapy, meditation, praying, if you are a person of a particular faith, then praying spirituality and focusing on what positive still is happening in your life. It would be harder to do but I was reading like a gratitude journal. Maybe this is the time to keep one. It is like every day, I will pick one thing to be thankful for. So like, you know, we say the maximum things could be better, but things could be worse. And I think we need to continue to focus on what is still working is still intact, or what can still be protected and salvaged rather than our losses. And if you need to pick Acknowledge the grief cries feel sad. It is okay, take time out to sit down cry, celebrate the lost the person that you have lost. Think about their legacy. Think about what they're what they achieved in their lives and what they were not able to achieve in their lives. What were the goals that were not met? If they have left immediate families that need care, there are so many ways we can still virtually care for each other. send flowers, send financial support for chickens still continue to do that. So it's gonna be a new way of doing things. But there is pretty much using same principles of self care and self preservation just integrating it to the new reality.

Linda Howard

Thank you. I know that.

Thank you. It's very helpful for me. Thank you

Latif, I have a

related question for you. Some of the stories that we've heard in terms of nurses, obviously one for where nurse says that every day she goes, she goes home and cries. Sometimes she cries because of what she's saying. Sometimes she cries because she's exhausted. Sometimes she cries because of the difficult choice that she had to make and that may have impacted who lives and who dies. So, if I were, if you think about, if I were a, you know, one of these individuals that had to make these decisions, and sometimes, you know, it's the same thing with the first responders where they're dealing with that, um, what kind of advice would you Latif give to them, as they're kind of struggling with these challenges.

Latif Rasheed

I mean,

That's a very horrible situation in every guard

Unknown Speaker

stories and reach me and reach everybody in terms of the hospitals and the ers and operating rooms and the medical personnel being just just a wash in and trying to try to care the mean and trying to be out there be on their A game exhausted, not equipped protectively, not being able to rotate out sufficiently work in extended hours is an unenviable situation and that in better times, that person could, you know, create some distance and then and

Latif Rasheed

but those persons

I mean the doctor can speak about that but those persons have their anxiety losted they are emotionally exhausted psychologically is awesome. It's called compassion fatigue. I mean, which is real, is the exhaustion comes from caring, caring about others and caring for others. There are some people we need to care about and there are other others we need to care for. But in this kind of situation, these persons wrapping in, you're referencing family and friends and loved ones can't come by. So whether it's the nursing staff or the men of the doctors or whatever, are a unwilling substitute in many cases I can imagine. I mean, so, in terms of caring for ourselves, like the doctor said is, you know, doing those doing those, you mean that we may not think they're important connections, but expressions of compassion, the main expressions of concern that To them, to the families to their loved ones. How can we assist them? Well, we can we can pray for them. There's been literature about if seven people I mean, I don't know to what degree but the seven people pray for you that has had an appreciable impact. I don't know in this situation. I think the other thing is that that not to switch to focus, but you know, we're we're all living as a brother using an expression we're all living on the verge there's an expression or a saying by mmm Ali Elisa Lam says that live this life as if you're going to live forever, but live for the hero. She's gonna die tomorrow, tomorrow that that ambivalence is it's a state of ambivalence of possibility. I might be here tomorrow and I might not be here. But we have this false consciousness that I'll be here forever. That mean, and I think that that's that that myth that that preoccupation or obsession with that myth exacerbates Our responses to trauma and loss when they when we are when we meet them and when they're brought to our awareness. We have an over we have an over response, but we live in that state of, of being on the edge constant possibility. Not only think that it will be humanizing for us or or sobering for us, but also increase our humanity possibly make us much more inclined towards being compassionate and tolerant and giving to others.

Dr Farha Abbasi

I would like to add one very important rule of self care, being aware of our own limitations, so I read something really beautiful a few days back. Your ego is writing checks that your body cannot cash. So as practicing Muslims, people of faith are natural. instinct is to reach out to give the most. And we are all feeling this need right now to do more

and to

kind of volunteer. So if you are a nurse, you might be taking more shifts or forced to take more shifts, being cognizant of your limitation that you can get tired too, you can get burnt out too. And the symptoms that we both talked about, to look out for, to the brakes, step away from trauma. Step away, create a distance from that and be cognizant that you did the best you could do. In the end, the outcome is not in our hand, we will be in death is inevitable we will be surrounded by death. This is a profession we chose to be around life and death. And this is heightened the senses heightened Right now, but to be cognizant of the reality, create a step backwards, take few minutes to yourself de stress, meditate, deep breathing because we start to breathe shallow, deep breathing, clear your mind and focus on what is possible. But one important thing is not to put so much. Don't expect that much from yourself. So make sure you add one thing like you said, the sleep Sleep Sleep you have to make sure you are sleeping, okay? You have to make sure you are eating okay? So if you are a caregiver, more so the reason that you've Take care of yourself, like you know that the cliche thing in planes that when the plane goes down and the oxygen masks drop, you're supposed to put it on your face first, even if you're sitting next to a child. So that's the thing we have to practice. Right now that if you are a caregiver start taking it starts with you taking care of yourself and be careful of for physical and emotional point out.

Latif Rasheed

Exactly.

Linda Howard

Does anybody if anyone on the call has any questions you can raise your hand and Erika, you opened up the chat line in case anyone wants to type anything in?

Erika Christie

Yep, yep. We're listening. So yes, the chat or the Q&A at the top.

Linda Howard

So is that Angela?

Erika Christie

Yep.

Dr Farha Abbasi

So one other thing is writing writing can be really helpful. journaling, painting, painting coloring, so continue to indulge in that it's not you might feel like these are selfish acts. I don't have time right now to do that. These are not selfish. This is self caring. If you need to exercise, take a warm bath, take extra time drinking your cup of tea, whatever it is small, small things that you can do for yourself are as important as taking care of others.

Linda Howard

I think I think your line is open Angela.

Caller

Can you hear me now? Yes, Yep.

Erika Christie

Yep, go ahead, Angela.

Caller

So like on first of all, I'd like to thank each and every one of you because This has really been something that

was really needed and in our country right now, it's very,

it's very daunting to feel like you have to navigate this alone. And, you know, we really do need community leaders and professionals to guide us and help us guide those that need guiding. So I from the bottom of my heart, I'd like to thank each and every one of you for your efforts for just putting on the webinars. My question was, are you going to provide links for the other two?

That happened previously support the people that weren't able to attend them live?

Unknown Speaker

And do you have suggestions of Further reading that we might be able to do specifically for teenagers who may be experiencing stress and struggles but may not be as verbal. The younger kids, you can hug and you can kiss and reassure. But teenagers tend to surprise themselves or sequester into their own faces and try and deal with things or maybe even talk to their friends. So do you have suggestions specifically to how we can

Caller

kind of help them before they verbalize it? They need help. Thanks you.

Linda Howard

Dr Abassi, let me just answer the easy question. Yes, we can make the recordings available. And if you register, we'll have your email and we'll send that out to you.

Dr Farha Abbasi

So maybe this is a question for you actually, is if he provide you resources, you can put it along with the recordings right? We can. Yes. So yes, definitely, we can add resources, but I just want to Take this moment that I hope you are aware that Michigan now has a mental health crisis helpline. And every city has a number that you can call. These are the new there national crisis hotlines that you can call and just simply talk. There are virtual spaces support groups available. So we will try and compile these resources and hopefully then can be posted along with the webinars.

Linda Howard

Yes, we can do that. Thank you. I know we're at the top of the hour. It's three o'clock. But if there's any other questions, if the panelists have a couple more minutes, I'll ask him that one and answer the questions. If anyone has to drop off of the recording. We will make the recording available. Okay. Is there any final question? Right. So I will ask, and a few seconds of Dr. Abassi and and Latif wants to give any final thoughts to everyone?

Dr Farha Abbasi

So my final thought is that being alone, not necessarily have to be lonely, that if we have social distancing does not need to translate into social isolation. There are a lot of ways that we can still continue. And I think one thing that you talked about teenagers, grownups, parents, whoever children, we all are feeling this need that it's natural. When we get anxious, depressed, we need to tend to keep things inside of us. And I think this is a moment to really communicate, be visible, communicate, talk to people The there is phone phones available you have FaceTime you have so there's virtually so many resources that you can still connect to people. And please, please please do not hesitate to ask for help. This is the time to speak up, talk about your emotions, please do not hesitate use these Crisis Line use the resources around you. And my advice to those of us who are kind of in forefront making these policies is we need to bring mental health mental wellness resilience in this conversation, no policy. Right now no program would work if we tend to focus just on one aspect of our health and neglect the other three golden rules. I always go with it. Education, empathy and engagement. And we I think those three have to be the ingredients and whatever initiative we go forward with.

Unknown Speaker

I think you know, perspective. I mean, it's overwhelming. Mostly everyone has been overwhelmed, but I think we should constantly remember that, that Allah is Allah. Mohit, I'm saying he is the all encompassing. There's no occurrence no situation No, an incident or critical incident. That out goes beyond his expansive. Rama is expansive. Compassion is expansive power, and you're saying as well as his awareness. So I think that they're they keep things in perspective, that our sense of trauma being traumatized being stressed is overwhelming. But we can delight dilute that in the realization that allows what a man allows Latif allows for dude, the loving, and that that is real. That's not just imaginary, but for our selves, to be kind, as the sister said, to be kind to ourselves and be kind to each other. I mean, and to remember, as we know in clan is that I live in decree late at night and Upolu doesn't the remembrance of a law, quell the hearts remembering a law, often remembering Yolanda's situation often, and us being very expressive about that I'm not trying to, I guess you call evangelize or anything like that, but nonetheless, that from from our, the center of our, of our values, which is our faith tradition, that from There comes a lot of strength, same from there comes our strength. And that in this situation, as someone really recently said, we oftentimes say, only when faced with death or hear the news of a death. Do we say in the delay, we're in a rush. However, we're all in the state of movement because the eye of the eye let's start with a lot of talking about loss of property, loss of wealth, and loss of lives. All of that. And anytime we should remember all out to that we're close to him that he has breathed into us. He said, He's closer to us than our juggler veins. That's so we're not alone. We're not alone. It may seem to be that way, but we're not alone. But the sense of community as a system, spoke out reference, email or phone calls and whatever that is even documentation that through not just through physical touch or physical hugging. But through initiating communication, it activates our parasympathetic nervous system. That's amazing. I mean, it's amazing to me, maybe other people. To me, I'm amazed at the main. So in terms of, we can do things that are extensions are extensions of our desire to touch our desire to hug and embrace. We can't do it right now. But we can do it virtually, with the intention that Heidi says that a mom would judge would judge every behavior by its intention. You can, we can make prayer, limited by by space or circumstance or illness. We can imagine ourselves praying. It's not, it's not a far fetched thing to imagine us being in, in Juma together and being the Jamaat together being connected in that regard. But we have to really be thankful for the options that we do have And the fact that we have the center and that center is the center of our hope, the main and our health, that's us in a source of refreshment, of anchoring ourselves of of our spiritual tradition and exercise of realities, even at the time of emergency like this.

Linda Howard

Ah, thank you. Thank you.

Dr Farha Abbasi

Can I say extended invite to Latif to please come and participate with Muslim mental health conference? We need you there.

Latif Rasheed

Take me through the technology maybe Oh, you know,

I'm having a technological meltdown. So that might be helpful. But thank you so much, sister. I really appreciate you all his work in Michigan. and admire that and I need to, I need to get my magazine subscription because I've been a little

resistant. Thank you so much for what you do.

Dr Farha Abbasi

Thank you same same to you.

Linda Howard

Stay safe. Thanks, everyone for joining our third episode of profound conversations.