Our routines have changed since the onset of COVID-19. Even if you are still going to work the normal number of days, the manner in which you prepare for work, execute your work, and return from work are all different. If you have been laid off, the change will be more dramatic. Maybe you were home on maternity leave when COVID hit. Maybe you were taking a break from medicine. Whatever your circumstances, the rhythm of your life has likely altered significantly. For those with children, you are dealing not only with the changes in your own routine and rhythm, but likely with the fallout from changes in your child’s schedule. Older kids are navigating distance education for the first time and likely grieving the loss of social outlets, spring sports, their final term as a senior, prom, perhaps even a graduation ceremony. Younger kids are missing out on socialization and the energy expending outlet of their local playgrounds. Even the great outdoors have their restrictions. Public parks/trailheads/and campgrounds have been closed in many areas leaving home as the only easy option. So much change can be exhausting.
In his book The Power of Habit, Charles Duhigg describes the powerful ‘ruts’ habits have made in our brain, and the mental energy that is conserved by allowing endless unthinking sequential actions to occur on autopilot. I suspect much of our current exhaustion results from our inability to rely on the countless routines and habits we have built up over the years. Instead, each action we take requires deliberate decision-making and mental involvement. In pre-COVID life we could grocery shop on auto-pilot, run errands on auto-pilot, arrive at work and adapt unthinkingly to the rhythm of the clinic, run through any number of client-education scripts, and the list goes on and on. All of these ingrained routines reserve focused attention and mental energy for tasks that truly deserve them: physical exams, interpreting diagnostics, family decision-making, helping with homework, etc.
Now grocery shopping requires attention to arrows on the floor, maintenance of a six-foot distance from other shoppers, a mask, and perhaps an acute awareness of everything you touch. Our routines now include additional handwashing and hand sanitizer. Wiping down of doorknobs and other frequently touched surfaces at work, maybe at home. Attempts to consolidate errands and shopping into small discrete windows of time. An actual inability to complete a number of errands due to closures. Not only are you helping with homework, you are now overseeing the entire course as well as troubleshooting technology issues.
Changes at work not only require attention in order to keep staff and clients safe, but also a double dose of the already difficult ethical decision making. Do clients get to come inside for a euthanasia? How do you convey compassion while delivering terrible news over the phone. How can you be sure your explanation of a complicated diagnosis or treatment plan is being heard. I can’t tell you how many times I have heard ‘yes’ and seen ‘not really’ in a client’s body language when asking “does that make sense?”.
How much history information are we missing because the kid who was ‘just along for the ride’ is no longer piping into the conversation? A classic example here is marijuana toxicity. Sure, we often take this one on without a definitive history, but confirmation allows relaxation and confidence in a way “top differential” does not. We also are missing the casual physical exam chatter that provides insight. Fluffy growls when you pick up his left hind… “oh, I forgot to mention, he had a tick on that leg, ever since I took it off, he’s been sensitive about it being touched”.
So the information we have to work with is reduced, the shenanigans necessary for each individual patient are increased five-fold, and staff and clients arrive at the clinic with a high baseline level of anxiety which doesn’t bode well for smooth conflict resolution. And, if you have any vulnerable family members, or are yourself at risk, it is hard not to consider that even with good distancing protocols in place, you are still being exposed. If you are an owner you have the added anxieties of wondering whether your business will survive while worrying about staff members whose livelihoods depend on you.
Routines free up mental space for contemplation, rumination, and problem-solving. At a time when we are dealing with life-altering current events our lost routines mean we have also lost a great deal of the mental space needed to handle those events. To add more stress to an already strained situation, consider how your self-care habits have been affected. It may also be instructive to look for self-care elements in routines that weren’t created with self-care in mind, but none-the-less conveyed benefit.
Let’s take the ritual of getting up, dressing, brushing your hair, making your bed, and having breakfast (alter as needed to reflect your own typical morning). None of these items really feel as though they fit in the ‘self-care’ category, however the power of ritual to influence our sense of wellbeing should not be underestimated.
So you’re not going to work today, you won’t be seeing anyone, you can’t go to the park or the coffee shop…. Why put on ‘real pants’? Why brush your hair? The bed can be made later today (if at all)….. Done intentionally, spending a day in pajama bottoms can be a delightful treat… done because the alternative takes too much energy or because ‘there is just no point’ means the day starts with a sense of defeat which can carry over into the remainder of the day. Children in particular rely on routines and structure to feel grounded and secure. Routines are the jumping off point and the point we return to. Without routines or rituals, however small, it is easy to feel adrift, and during the current storm, adrift is a lonely and perhaps scary thing to be.
It is important to appreciate the strength of small rituals and routines as they activate downstream moods, habits, and states of being. If your pre-COVID routines aren’t working, consider creating small daily routines to help revive a feeling of order, predictability, and accomplishment. Routines offer comfort and a sense of control during these unstable, unpredictable times.
Notice I said small. While you may feel genuinely inspired to revolutionize your exercise and cleaning routines while sheltering-in-place, new routines can be as simple as making your bed, having a cup of tea with a book in the evening, or walking to the mailbox instead of picking up your mail on a drive by. If you do have more unstructured time than usual, I recommend this time be spent cultivating long-term routines of self-care and prioritizing your mental health over an ambitious to-do list. Practice self-compassion and give yourself enough grace to see that a messy house and incomplete projects are normal consequences of a disrupted life, not evidence of ‘failure’ or ‘laziness’.
Finally, it is important to consider that some pre-COVID routines and habits may actually be harmful to your current mental health. If you were previously a person who scanned news headlines before each meal, consider limiting your intake to once daily if you find yourself repeatedly stressed after checking the news. If your routine was to call a parent once weekly before, maybe it would feel better to check in more frequently.
Today’s handout will ask you to assess how routine and loss of routine have been affecting your ability to care for yourself and to participate in your caretaking roles. By carefully evaluating what has changed and what has been lost, you will have the knowledge necessary to deliberately craft new routines that will free up mental space and hopefully improve your wellbeing.
This concludes Part 2 of the three-part COVID-19 Self-Care Package. For Part 3 continue on to Salvaging Self-Care. If you missed it, return to Part 1: Overcoming Overwhelm. The TLC Wellness Journey will continue with a blog post and podcast release each Monday. Self-study handouts and additional resources will be included on a regular basis. I invite you to follow my blog, subscribe to my podcast, and sign-up for my Newsletter to keep abreast of my latest work.
Take care always,
