GUIDELINES FOR PSYCHOLOGICAL CARE DURING QUARANTINE

GUIDELINES FOR PSYCHOLOGICAL CARE DURING QUARANTINE

Provided by

Clinical Unit of Psychology (UNINPSI) of the Universidad Pontificia Comillas, Madrid, Spain

APPENDIX 1: PSYCHOLOGICAL TIPS FOR SELF-CARE

Throughout the quarantine it is normal to go through different moments and emotional states: stress, anxiety, loneliness, frustration, boredom, anger, feelings of fear and hopelessness, etc. These effects may last or appear even after confinement. 

Taking care of your actions, thoughts and feelings will be of great importance in responding appropriately to periods when your mood may fail and the feeling of uncertainty or uneasiness grows, if at all. 

We offer you a series of recommendations, from a psychological point of view, in case you find yourself in any of the following three scenarios: (A) you are in isolation but not affected by the disease; (B) you belong to the population at risk; (C) you suffer from the disease by infection of COVID-19. Some of these scenarios have already been discussed in previous sections of this guide, but they are summarized here. 

(A) IF YOU ARE IN ISOLATION, UNAFFECTED BY THE DISEASE, BUT ARE NEVERTHELESS FEELING ANY OF THE FOLLOWING EMOTIONS - OR OTHERS WE HAVE NOTED ABOVE - PERSISTENTLY OR WITH HIGH INTENSITY: 

- Nervousness, agitation or tension, with feelings of imminent danger, and/or panic. - You can't stop thinking about anything other than the illness or worrying about getting sick. - You need to be constantly seeing or hearing information on this subject and have difficulty in taking an interest in other issues. - You find it too difficult to concentrate, to carry out your daily tasks, to do your work properly or you are paralysed by fear. - You are in a state of alert, continuously analysing your body sensations and interpreting them -not being pathological signs- as symptoms of illness. - You find it difficult to control your concern and you persistently ask people around you about your health, warning them of the serious dangers they are in given the situation. - You avoid contact with other people too much for fear of contagion. - You notice an increase in heart rate, rapid breathing, sweating or trembling without good reason. - You have difficulty in maintaining a restful sleep. - Your emotional problems get worse or return after they have been overcome. 

THEN WE RECOMMEND THE FOLLOWING: 

1. Identify the thoughts that make you uneasy. Constantly thinking about the disease can cause symptoms to appear or become more pronounced, which can increase your discomfort. Try to talk about what you like or are excited about. 2. Recognize your emotions and accept them. If necessary, express and share your situation with the people closest to you - those who give you confidence - to find the help and support you need. People who appreciate you will probably feel better knowing how you feel.

3. Question what you are experiencing and look for evidence of reality. Know the facts, and trust the information provided by the official scientific media. Be aware that, from some forums, alarmist images can be transmitted, and over-information given from a negative perspective, magnifying the phenomenon and making you perceive greater threat. 4. Avoid information saturation. Living permanently connected will not make you better informed and, on the contrary, will increase your sense of risk and nervousness unnecessarily. 5. Go to official sources and look for proven information from experts: Ministry of Health, Official College of Physicians, World Health Organization, other official organizations, etc. 6. Check the information you share, especially if you use social networks. 7. Don't contribute to the dissemination of false news and hoaxes. Do not feed your fear or that of others. 8. Carry out the appropriate hygiene habits recommended by the Health Department, but remember that this is not the only thing you have to do throughout the day. 9. Avoid talking about the subject all the time and look for other areas of conversation. 10. Support the members of your community, fellow priests, family members, collaborators of the apostolic work to which you belong, etc. 11. Help those around you to remain calm and to develop adaptive thinking in each situation. 12. Try to make life as normal as possible and continue with your usual routines, within the situation in which we find ourselves. In areas where you cannot keep up, reorganize your schedule. 13. Beware of behaviours such as rejection, stigma and discrimination. Fear can cause us to behave impulsively, rejecting or discriminating against certain people. If you have felt this way in recent days, also try to understand that some people are even more nervous, and that most likely it was not a direct attack on you, but the result of their discomfort.  

(B) IF YOU BELONG TO THE POPULATION AT RISK: 

1. Follow the recommendations and prevention measures as determined by the health authorities. Trust them.  2. Get informed in a realistic way and follow the guidelines suggested in previous sections. 3. Do not trivialize your risk to try to avoid the feeling of fear or apprehension of the disease. Pretending that nothing is wrong is a natural way for human beings to protect themselves from what is causing them distress or great concern. But it is healthier to talk about what you are worried about or afraid of so that you can deal with it without having to hide it. 4. Don't magnify your actual risk. Be cautious and prudent without being alarmed, knowing that sometimes we can also exaggerate to relieve and protect ourselves from what frightens us. 5. Don't take actions that compromise you, pretending to feel unrealistic invulnerability. Avoid behaviours that encourage addictive behaviours.

6. Be objective and adopt a global perspective. Think that many scientists throughout the world are working on the issue and are providing us with advice to solve this situation in the best possible way. 

(C) IF YOU ARE SUFFERING FROM THE ILLNESS: 

Follow the recommendations above and, in addition: 

1. The more unknown a disease is, the more restlessness it can generate. However, try to manage your intrusive thoughts: don’t put yourself in the worst position in advance. 2. Don’t be unnecessarily alarmed. Be realistic: most people seem to be getting well. 3. When you feel afraid, rely on the experience you have from similar situations. You may not associate it now because you have a more serious perception, but it brings to mind how many difficult illnesses or circumstances you have successfully overcome in your life. 

 

APPENDIX 2: RELAXATION EXERCISES

Below we propose three types of exercises that can be useful if you think you need a space for relaxation. There are several variants and different modalities. Some people find them helpful to help with their emotional integration. That is why we suggest them. However, each individual finds benefit in different techniques. If you feel that these do not help or satisfy you, feel free to find what works best for you.

 

BREATHING CONTROL 

It is not difficult for you to experience some feelings of anxiety throughout the quarantine. One of your symptoms is shallow breathing. We offer you a simple technique that you can practice anywhere: breath control. 1. Breathe in through your nose instead of your mouth. 2. Breathe gently and deeply several times. 3. Notice how your abdomen widens on inhalation and narrows on exhalation. 4. Take a couple of deep breaths in through your nose followed by slow, gentle breaths out through your mouth. 

DIAPHRAGMATIC BREATHING 

This technique needs a little more training and a quiet place where you can concentrate on it. 1. Get into a comfortable position and try to relax your muscles. 2. Place one hand on your chest and the other on your abdomen. 3. Breathe in slowly through your nose, extending it to your hand on your abdomen. The hand on your chest should remain still. 4. When you get the air there, hold it for a couple of seconds. 5. Release the air slowly through your mouth, so that you feel it go dropping the abdomen, and the hand on the chest remains motionless. 6. Repeat this exercise several times. 

VISUALISATION 

This exercise combines relaxation techniques with meditation. 1. Find a comfortable and uninterrupted place. 2. Light up the space in a soft and pleasant way for you. 3. Play music at a low volume, enough to be heard but not to disturb or distract you. 4. Close your eyes and concentrate on your breathing. Feel the air coming in through your nose and going out through your mouth. 5. Think of a blue sky. Feel the energy the sun gives you and focus your attention on the feeling these days give you. 6. Enjoy the view of the sky for a few minutes. 7. Add the sea to your vision. Listen to the sound of the waves. 8. Flood your brain with the vision and focus on the feelings it brings up. 9. You will be more and more relaxed. When you do, visualize yourself, in that landscape, lying on the grass or on the sand of the beach, with no one around you.

10. Enjoy the feeling of relaxation and peace that floods you for a few minutes. 11. Visualize yourself getting up in the landscape and start stretching your muscles of the body, little by little and without opening the eyes. 12. As you stretch, also become aware again of the music that surrounds you. And, when you are ready, open your eyes slowly, without hurrying, in peace.