Prologue from Book to be Published in 2024

There was something different about the decorations in my fourth-grade classroom. I was accustomed to seeing cursive writing posters, displays of student artwork, and bulletin boards with numbers to help us students learn the basics of mathematics associated with early grammar school learning.

However, this classroom had colorful posters, and one stood out. It was an abstract of a guy playing a saxophone, but the message resonated with 9-year-old me: “When life gives you lemons, make lemonade!” I had some insight about what “when life gives you lemons” meant, because two of my friends had parents going through difficult divorces. 

But Mrs. Atkinson told us fourth-graders during the first week of school that most people face problems in their lives and sometimes those problems can be quite hard (or bitter, she said, “like the taste of a lemon”). She asked the class whether anyone ever bit into a lemon, and Jenny made a funny face and confirmed that lemons tasted bitter. Then Mrs. Atkinson gave us all a small paper cup of lemonade, and she was right again. It tasted great 

***

Coping with and adapting to those obstacles we all encounter in life often results in happy outcomes (the sweet taste of a well-made lemonade), Mrs. Atkinson assured us kids. She was the first teacher who gave us a significant amount of homework, since “you are fourth graders now.’

“You may not like all the assignments,” she said, “but I want all of you to be as smart and happy as you can be by the end of the school year.”

You see, Mrs. Atkinson had high expectations of her students. For those who struggled with verbal comprehension, she expected them to find books to read with a parent or older sibling to increase their vocabulary. For those who hated math, she assigned additional worksheets to reinforce the concepts she was trying to teach. For those who spoke out of turn, the student would get a time out to watch in silence, and then have an opportunity to share an “observation,” as she called it, with the rest of the class.

***

Frequent offenders to this last point were sent to the principal’s office, and none of us wanted to be Tommy, the student most often sent packing. When Mrs. Atkinson got upset with a student, her face turned real red. Even then, however, she was direct, patient, and never shouted.

One day, I finished a test early, and while sitting quietly bored at my desk I tied my jacket sleeves into a knot and found myself tied in place to it when the fire alarm rang. As the other students quickly exited their seats and left the classroom, I was struggling to undo the knots and could not successfully leave the classroom on time. I saw Mrs. Atkinson’s red cheeks waiting at the classroom door for me to untangle, but she didn’t intervene. Once I had escaped from the knots and after she had counted her students outside on the playground, she made it clear to me that I would stay after school for a “little discussion.”

As a child, I was not typically the troublemaker, so this teacher-student meeting would be a new and scary phenomenon for me. Mrs. Atkinson asked me to explain to her what had happened. She quickly realized that I was embarrassed about tying myself into the seat and recognized that I had been bored; so she offered me a deal: I could keep a book inside my desk drawer compartment so that I could read quietly whenever finishing an assignment or test early. If I complied for the rest of the school year, no other discipline for literally tying myself in knots would be necessary.

I avoided being the source of Mrs. Atkinson’s red face for the rest of the school year; Tommy remained the most frequent subject of her red-cheek attention. By the end of the year, the teacher recommended to my parents that I serve on the safety patrol during fifth grade. That was the lemonade: getting recognized as being trustworthy and having learned a valuable lesson.

***

In retrospect, Mrs. Atkinson likely embraced Piaget’s four stages of cognitive development. Between the ages of seven and eleven, children are involved in the Concrete Operational stage, at which time they begin to think logically about concrete events, become more organized, and begin to use logic to apply to specific situations.

Mrs. Atkinson helped me recognize the potential danger of the situation if the fire alarm been associated with a real threat. But she also taught me that it was my responsibility to read books and stay out of trouble when finishing an assignment early.

What I hope to accomplish with Diminishing (Your) Worry and Stress is to share some real-life stories—mine and those of others I know—to figure out how to make the lemonade. I want to utilize my own training, education, and life experiences to offer a few life lessons to anyone who wants to recognize and cope with worry and stress in their lives. These are lessons that I have learned, and that my clients have learned, sometimes the hard way, and that we all can continue to explore together.

So, this is just a collection of stories, with names changed unless specifically approved; yet the stories are authentic, I promise you. And I hope it will be more of a dialogue with you than a dissertation from me. May you learn as much from reading the book, as I have learned from writing it.

Beyond the Perfect Storm

Due to the convergence of three major forces: systemic racism, COVID-19, and economic calamity, a tsunami of mental health conditions has swamped millions more Americans during 2020. The recent statistics on suffering are staggering: “Overall, 40.9 percent of 5,470 respondents who completed surveys during June 2020 reported an adverse mental or behavioral health condition,” the Centers for Disease Control and Prevention says in its Morbidity and Mortality Weekly Report.

Anyone who is experiencing severe worry or hopeless thinking in response to these major forces should contact a licensed clinician for therapy services.  This article will focus on resilience strategies for coping with current forces that are challenging us as individuals and as a community.

The groundbreaking work of British based family physician Mohan Kumar identified eight characteristics of resilience that are the keys to positively adapting to stress or adversity.  Given the forces of the pandemic, systemic racism, and economic adversity, we are called to channel the resilience within ourselves to finish 2020 with our physical, emotional, social and financial well-being intact.

Connectedness:  One of the key attributes of resilience is staying connected with a support network of friends, family and peers. Resilient individuals seek connections and accept help from those who care about them. They reciprocate this support and try to help others in times of need. Belonging to social groups that are mutually supportive helps build resilience.  LGBTQ persons often identify a family of choice, beyond our family of origin, to have allies and confidantes who support us for who we are and what we stand for as open, out individuals.

Curiosity:  Resilient people stay curious. They maintain a sense of wonder and awe. They are curious about what has happened and what will happen. They are curious about how they feel and how they could feel. They are reflective and mindful of themselves and others’ thoughts and emotions.  Being diligent about seeking reliable sources of information about remaining safe from COVID-19 or recovering from the impact of COVID-19 with skilled physicians and other care providers is essential.

Communication skills: Resilient individuals develop their communication skills. They can articulate (internally and externally) their challenges and their coping strategies. They can communicate their viewpoints while actively listening to others.  Resilience requires channeling our anger about matters like systemic racism effectively by expressing any additional feelings of sadness, worry and shame in a manner that produces good trouble as Rep. John Lewis would refer to including constructive conversation with those whose opinions differ from ours and subsequently engaging in peaceful protest to seek change.

Control & Crises Management:  Resilience comes from a sense of control. Resilient individuals get beyond the temporary feeling of loss of control and make decisive actions. They do not shut themselves away and hope the trouble goes away. Staying decisive in times of adversity is hard but helpful. Resilient persons do not view crisis as a tragedy of immense proportions. They maintain a long-term view. They view crisis as a milestone, a chance to improve, to change strategies and regroup. They get past the initial emotional response and think beyond towards solutions.

Change Acceptance:  Resilient individuals accept change. They view change as a path to growth rather than a hurdle. They perceive things that can be altered while accepting certain things that cannot be changed. This helps to focus on things we have control over rather than get distressed over those we cannot.  For those who have experienced recovery from substance abuse, change acceptance is the overall theme of the Serenity Prayer.

Clarity of Focus:  Resilient persons make bite sized objectives and stay focused on achieving them. They break odds into surmountable chunks. They are realistic yet ambitious. They are content with making incremental progress towards their goals and seek positive feelings from small successes.  The athletes who have engaged in Black Lives Matters protests and subsequently increasing opportunities for persons to vote demonstrate this clarity of focus.

Confidence:  Maintaining a positive view of oneself helps build resilience. Moving away from negative emotion and catastrophizing while nurturing a positive self-image is quite helpful in times of crisis.  Ask your spouse, partner, or confidante to identify your greatest interpersonal qualities if you need to boost your self-esteem.  If you lost a job due to the pandemic, do not personalize the loss and keep focused on the skills and strength you will bring to a new employer while seeking a new job or career opportunity.

Creativity: Learning a new skill helps to bolster resilience. An artistic expression such as music, dance, cooking, meditation or creating art also builds resilience. The positive buzz from artistic endeavors has a healing effect particularly when we feel outrage, grief, or sadness about the challenges of 2020 and channel those energies into creative outlets.   Thinking outside the box can yield wonderful results in building new friendships, finding a new career, affirming artistic talents, and standing up for your beliefs.  Take note of how Smart Ride is adjusting its usual schedule of events to minimize COVID risk exposure yet still raise a million dollars for HIV/AIDS organizations throughout the State of Florida.

Our Southeast Florida LGBTQ community has been challenged to move forward with the circumstances of 2020 that has us being physically distanced due to COVID-19.  Theatre and musical groups are adjusting ways to deliver their artistic performances through a combination of live audience and camera feeds.  Sports teams have been off the field and gathering in small groups outdoors sharing meals and fellowship to maintain connection.  Emotional support groups and 12-step recovery groups are meeting via video consultation, hoping to avoid “Zoom burnout.”

Members of the LGBTQ community have been actively supporting Black Lives Matter events engaging in non-violent protest about racial injustice.  Advocates are strategizing about how to ensure that November 3rd ballots are received, returned, and counted. 

Resilience includes keeping your interpersonal connections with your allies and confidantes who are present and support you through times of adversity.  Do not hesitate to seek therapy for supportive counseling to cope with the emotional impact of COVID-19, racial inequity, or economic uncertainty.  We are all in this as one rainbow community united together!

Recommendations from CNN Medical Analyst about Thanksgiving 2020

(CNN)If you want to visit your family for Thanksgiving and avoid passing coronavirus on to them, experts say you need to quarantine for 14 days.

That's two weeks of doing even less than we're doing now, and it needs to start today.

CNN talked to CNN Medical Analyst Dr. Leana Wen, an emergency physician and a visiting professor at George Washington University Milken Institute School of Public Health, to find out what that entails. Here's her guidance.

CNN: Why do we need to quarantine before seeing relatives?

Dr. Leana Wen: The United States is suffering through the worst part of the pandemic that we have seen yet. We have added 1 million new infections in just 10 days. Hospitals in multiple states are already diverting patients because their emergency rooms and intensive care units are too full.

Remember that people we love can carry the virus as much as strangers can. When the level of virus in the community is so high, it's not safe to get together in person, indoors, with anyone not in your immediate household bubble. 

If you want to get together with other households for an indoor Thanksgiving, you need to quarantine for 14 days and then get tested.

CNN: Why is quarantine 14 days long?

Wen: Fourteen days is the maximum incubation period for the virus that causes Covid-19. If you quarantine for less time than 14 days, you could be infected and not know it. I am certain that none of us would want to inadvertently spread Covid-19 to those we love the most. Taking a test too early -- before a 14-day quarantine -- may not pick up on the infection.

CNN: What can we do during our quarantine?

Wen: In this case, quarantine refers to staying away from others and minimizing your risk as much as you can. It doesn't mean staying locked in your house. Getting fresh air is good and important for your physical and mental health. So it's fine to take walks and exercise outdoors. Try your best to stay away from other others, and keep at least a 6-foot distance when outdoors.

We know Thanksgiving can involve a lot of cooking, and therefore grocery shopping. Going to the grocery store can also be low risk, although you should try to go during off-times and try to go just once during your 14-day period. You could also try to order groceries or the entire meal to be delivered to your home.

CNN: What should we not do?

Wen: Here's what's high risk and should be avoided during this period. Do not go to indoor bars or restaurants. Avoid gyms. Most important: do not get together with anyone else outside your household for anything indoors -- no dinner parties, no birthday celebrations or any other get-together indoors. If you are socializing outdoors, make sure you keep a 6-foot distance from others at all times.

If you're getting together with other households for the holiday, you should discuss what other activities you would be OK with. Many doctors' offices have put in place precautions and it's probably low-risk to visit the doctor. Many workplaces have instituted many protocols to reduce risk, and it may even be very low-risk to go to work if you can keep at least a 10-foot distance from others and wear masks at all times.

CNN: Does everyone have to quarantine?

Wen: Yes. The key is that every member of every household that wants to get together must participate in the quarantine for 14 days. If one person breaks quarantine, that person is exposing everyone else to their risk. This requires a lot of trust, so set that expectation in advance.

CNN: What about daycares and schools?

Wen: This is a tough one. Daycares and schools may be necessary for a lot of families when it comes to childcare for working parents. They may be relatively lower risk for transmission, especially for younger children. However, there is an infection risk, especially given the high level of coronavirus across the country. I would not consider a family that's still sending kids to daycare or school to be low risk enough to be part of an indoor celebration. But if kids stop daycare or school now and then get tested in 14 days, they could see other relatives indoors.

CNN: Can we still see one another if we don't quarantine for 14 days?

Wen: Yes, but you can only see them outdoors, with households spaced at least six feet apart. You can still host safely and have fun! But do not get together indoors.

CNN: Are there other ways to celebrate if we can't get together with our family?

Wen: Yes! Being safe doesn't mean we should stay isolated. Maybe we can't get together in person with family. You can plan an outdoor "Friendsgiving." Bundle up and bring warm blankets. Be flexible if it turns out that we can't celebrate Thanksgiving on that day because of the weather.

CNN: What if we have to travel to see family for Thanksgiving?

Wen: I'm less concerned about the travel itself than the activities before the travel. The 14-day quarantine period should happen before the travel. Then do everything you can to minimize risk while traveling.

CNN: Is driving better than flying?

Wen: Driving will be safer than flying because you can control who's in your car. Keep rest stops to a minimum. Make sure to wear a mask if you're using a public restroom and sanitize your hands after leaving. Even flying has relatively low risk, with only a handful of infections reported for flights where everyone is wearing masks. Make sure to wear a mask the entire flight, ideally an N95 or at least a 3-ply surgical mask.

Still, I urge everyone to reduce nonessential travel. Even though the travel itself is low-risk, I worry about people coming from all over the country, since nearly every part is a coronavirus hotspot at this point.

CNN: What about college students coming home for the holiday?

Wen: Many colleges have had outbreaks. Young people tend to be asymptomatic spreaders, and returning college students should be treated as being very high risk.

It's probably not practical for students to quarantine for 14 days before they return. In that case, they need to quarantine once they return home. That means staying in an area of the house that's totally separate from anyone else. They should not be in any indoor areas with other people for 14 days. They can socialize outdoors only during that period.

CNN: This is a lot. Is it really necessary?

Wen: Yes. I know it's a lot. But we have to get through this winter. There is hope on the horizon, with a vaccine and therapeutics likely next year. We need to get to that point. That means we have to keep up all these precautions. Wear masks. Physical distance. Wash our hands. Avoid indoor gatherings.

We've already endured so many sacrifices. We can get through this winter, together.