Psychological Care Guidelines During the Quarantine Period for the Religious and Priestly Life

We post this document that it may help you and your community or presbyterate during these challenging times. It comes to us from Fr. Alberto Cano, SJ (Spanish Province of the Society of Jesus), a former psychiatric intern at the Saint John Vianney Center who is currently working on the front line at a hospital in Madrid, Spain, an epicenter during this pandemic.

In these last few days, we have been facing a situation that, for most of us, is new and involves a major change to our routine, work, schedule, tasks, activity and mission focus. We must adapt to a reality that has been imposed on us in a relatively unexpected way which is not easy to manage; however, with a spirit of trust and confidence in the Holy Spirit, we can use this moment as an opportunity for growth and creativity.

For this reason, the Team of Religious and Priestly Life of the Clinical Unit of Psychology (UNINPSI) of the Universidad Pontificia Comillas wants to offer a simple guide with some instructions for the psychological care of the religious communities and priestly life. We hope that in this time we can continue to take care of each other responsibly –those near and far– so that everyone can feel accompanied in their medical, psychological and spiritual needs.

Preambles

  1. Understanding profoundly the reality that you are living in and adapting to it will be very useful. It is important that you recognize the situation in which you are living –personal, communal, social, ecclesial– and live it out with sincerity and seriousness without generating unnecessary panic and alarm.
  2. Keeping yourself informed is good and necessary. Ensure that you receive official, adequate, sufficient and truthful information. However, too much information –especially through the internet– can generate, in some people, psychological distress. Information overload can cause feelings of unease, anxiety, fear, over-reactions, irrational behavior, negative thoughts and other emotional reactions that ultimately backfire. Avoid becoming saturated and overloaded, especially when it comes to data and reports that are unconfirmed and come from unreliable sources. It may help you to plan a few specific moments throughout the day (probably no more than three) to inform yourself about the current situation using only trusted and reliable sources.
  3. Follow the recommendations of official agencies and the action plans developed by them: the Department of Health, local governments and officials, experts, etc. Above all, pay attention if you live with someone who shows symptoms of infection, who has been infected or who needs isolation.

Life Together

You will probably spend more time and share more space with your fellow community members over the course of the next few weeks. This situation provides an opportunity to live fraternally and with a unity of spirit. But it also requires that we be attentive so that this new scenario of communal life may be, at the same time, a place of encounter, peace, closeness and freedom.

  1. First of all, remember that we are not all the same and we do not respond to a situation of tension or a moment of difficulty in the same way. Try to understand how others respond and don’t dwell on your own responses with unnecessary angst or guilt. If necessary, find moments of greater calm and serenity to talk –in an honest and mature manner– about what is happening.
  2. Generate alternative conversations. There are a lot of diverse topics to talk about, find them and take advantage of the time, doing so with less haste than usual. Expand your view of other realities and people in our world. It is also a good time for spiritual conversations which offers a space for listening and reflection. And above all, do not abandon a sense of humor.
  3. Collaborate with your community or with the people you live with in planning out this new situation. Establishing a certain orderly rhythm in communal life as well as your own personal life will favor a psychological well-being. It is a time for creativity: think of possible celebratory events you can have, different types of communal prayers to share and also recreational activities (movies, board games, reading recommendations, etc.) that favor a positive atmosphere and a certain distraction. Kitchen and other household tasks can also be very helpful.
  4. Try to keep community schedules that encourage exchange and conversation, always keeping in mind health recommendations. A clear outline, accessible to all members of the community, which favors the participation of young and old, will be beneficial for everyone.
  5. Pay special attention to your assignments and tasks within the community or the institution to which you belong. At this time, diligence is a concrete form of care for the other and it is key to the group functioning properly.
  6. Respect the common spaces and times of silence. It is not surprising that you now feel more sensitive to noise, loud conversation or other disruptive sounds. You may also feel more sensitive about using common areas. Think about how others will experience something similar.
  7. Receive and convey messages and information about the pandemic, quarantine and other circumstances related to COVID-19 in a careful and constructive manner. Avoid gossip, unsubstantiated rumors, and one-time comments about the issue so as to not create unnecessary tension or community hardship. Constantly talking about this issue can increase fear and distance yourself from greater states of calm and tranquility. Give yourself a schedule to receive news –a maximum of two hours a day at three different times– and, once the time is up, move on to an activity that generates well- being or a hobby that you enjoy.

Personal Life

  1. Although life goes on in a different way, it is good that it does. If it helps, make a personal planning schedule that creates routines and encourages you to maintain a certain level of activity. You can adjust it later as many times as you like, depending on how you feel and how things are going.
  2. Take advantage of the time you are living. You have probably been forced to reduce tasks, both personal, communal and mission oriented. This may have left you with more free time than usual. Use it to do activities that help to generate positive thoughts and emotions: reading, deepening in some subject of your interest, taking personal notes, reflection, etc.
  3. Do physical exercise at home. If you can’t think of how to organize this, there are different applications and tutorials from which you can get ideas and then adapt it to your liking and ability. Sports activates your body, reduces the symptoms of sadness or anxiety and increases the feeling of well-being. Also try to get some natural light and maintain some kind of manual work. Take special care with your diet: anxiety goes straight to the stomach. Another possibility is to spend some time each day doing relaxation exercises, which can be useful in reducing the consequences of quarantine. You will find a guide to this in Annex 2, which is included at the end of the guide.
  4. Respect personal space and time. We all need, to an extent, moments of solitude, silence and personal autonomy. Once again, we do not all function the same, but each has his or her own requirements and demands; get to know yours and allow others to follow their own way. For some people, a certain level of isolation contributes to mental balance.
  5. It is time for peace. However, in our communities, presbyteries, convents, monasteries, institutions, seminaries or houses of formation, conflicts exist. Although we would surely like it not to be so, this is a reality that we cannot ignore. However, now is the time to work on understanding, kindness, patience and forgiveness. It is time for Lent, not for conflict and we need each other. It is time, therefore, to presume the best intentions of our neighbor and to fast from resentment, envy, quarrels, criticism and disaffection.
  6. Take care of your more fragile companions. Especially if you live with older people, people who are sick or who require special attention. They may feel vulnerable, fearful, reluctant to say something so as to not raise a false alarm and thus, they remain silent, unwilling to express their concern. You don’t need to harass, but you can be aware and available, with humility and discretion, for what they may need. If at any time it is you who finds yourself in this situation, do not be afraid to communicate it: I am sure that you have someone close to you who wants to lend a hand and help; moreover, it is a gesture of responsibility towards the people with whom you live.

The Life of Prayer and Celebration

We are accustomed to a way of functioning where dynamism, speed and urgency take the lead, affecting our religious and priestly lives. This concrete moment that we are living in can help us enter into a different dimension. This slow down which has been imposed on us brings us closer to our interior life and all that happens within it.

  1. This time in which we find ourselves can be of great help if we look at what is happening with eyes of deep faith and try to process the reality that is present before us as a propitious time.
  2. We are in Lent, and during this liturgical season of the Church we find ourselves in quarantine (Lost in translation: “Lent” in Spanish is “Cuaresma”, which is related to “cuarentena”, the equivalent of “quarantine”.) . Here too, prayer, fasting and penance are possible and necessary; and, as in every age, they continue to lend themselves to creativity.
  3. We are offered an opportunity to strengthen spiritual reading, personal reflection and prayer life. We live in an ideal time for reading, which is one of the best ways to link dreams, thoughts and feelings; because books help us to go beyond ourselves and connect with the deepest part of each person. It is also an appropriate time to make a prayerful, personal and deep reflection of the special situation we are living. Time, of course, to pray personally and communally in a way that is perhaps even more creative. And, in this sense, to commit special attention to the lives of those who are suffering more painfully from the disease; to pray for their families, who may not be able to accompany them in the way they would like; and to pray for so many professionals –from the health care world and other areas– who give the best of themselves in their work for the common good.
  4. Although in some institutions it is not possible to participate in the Eucharist or other sacraments as a community, it is time to pray together and to savor the Liturgy of the Hours in a new way.
  5. It is also a time to have spaces where we can converse spiritually. Sometimes these spiritual conversations begin simply with a question about how we are living this new reality. And time, even if we find ourselves surrounded by fewer people, to feel sustained and accompanied by the prayer of the whole Church.
  6. This is a propitious time for us to live where penance and fasting have a special relationship with the care of the other who is next to us.
  7. There are also digital platforms, offered from different ecclesial spheres and institutions, which can help us to live this moment through social networks, as long as they do not lead to isolation. One of them is the initiative at home with God, developed by the Spanish Province of the Society of Jesus. It is an Ignatian proposal to make this time a time of grace. It offers the celebration of the Eucharist streaming every day at 20:00; a prayer guided by Instagram live, three days a week, at 22:15; an interactive talk with the team of vocesesejota; and, in addition, special prayers and articles on the web platforms rezandovoy and pastoralsj.

Life Outward

The situation of confinement that you are experiencing does not prevent you from continuing to participate in your apostolates and your mission. You will just have to do it in a different way than from what you are used to. However, your presence –even if it is virtual– can be very important for people who do not live with you. Here are some simple guidelines that may be helpful:

  1. Use technology to stay close to your those dearest to you and the people in need. It is a good time to continue strengthening conversations with colleagues from other religious communities, from your own congregation or others; priests; people from your apostolic works or parishes; family members; or any other group that you feel needs a call or a simple message. Talking with them about how you are facing this new reality, how you are living this special time internally, or what you do in your daily life, can help not just yourself but them as well. Avoid generating restlessness, fear, irrational uncertainties and unnecessary panic.
  2. If at all possible, make use of video calls in which you see yourself with others. This is a way of compensating for the absence of physical contact, as well as generating serenity and calm.
  3. Stay connected to vulnerable people. Especially with the elderly since they are currently the most fragile because of their loneliness and physical weakness.
  4. Try to maintain contact with fellow apostolic missionaries, parish priests, parochial vicars, etc. You can share situations specific to your work or parish and generate a network of collaboration between different people or institutions close to you: support groups for vulnerable people, sharing of social networks for useful and accurate information on developments, virtual spaces for prayer, training, etc.

Conclusion

At the same time that we are going through this situation of quarantine and confinement, we are also going through the Lenten journey. Behind these weeks of confinement there is much more than forty days of resistance and confinement. It is also possible to sense, in the midst of what is happening to us, the presence –continuous, mysterious and disconcerting at the same time– of our God, who does not close his doors to anything or anyone. During this time, there are many biblical images that can come to mind and intensify in our prayer: desert; combat; thirst; longing; passion… But, above all, we want to keep our eyes on the One in whom we trust: the Lord Jesus, Crucified and Risen for us. He is the water that quenches our thirst, the light in the midst of perplexity, the life that –in the depths of nonmeaning– fights to spring up.

We too need to take care of ourselves. We form part of a pluralistic Church in which each of us –priests, members of institutes of consecrated life and societies of apostolic life, seminarians, laity– has a mission that comes from God. We want to continue our commitment to service and help; and, at the same time, we need to learn that we cannot do it without caring for others. The contemplative life possesses deep strength and profound intuitions with which you can illuminate us.

Certainly the situation in which you now find yourself in will differ depending a lot on whether you read these pages from a monastery, a convent, a flat, a parish, a residence, an infirmary, a college, a house of welcome, a hospital, an insertion community, a seminary or a house of formation. We are also aware that the guidelines that we offer you might not be able to give you an answer to all the questions and concerns that may arise from your concrete reality. But we hope that this will serve you as a humble guide that will bring you some light. In that we trust. AMDG.

Annex I: Psychological Clues for Self-Care

Adapted from the communiqué of the Colegio Oficial de Psicólogos de Madrid: “Recommendations addressed to the population for effective coping with the psychological distress generated by the outbreak of Coronavirus – COVID- 19”.

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 reappear even after confinement.

Paying attention to your actions, thoughts and feelings will be of great importance in responding appropriately to periods of mood swings and when feelings 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 due to infection of the 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, not affected by the disease, but nevertheless you are feeling some of the following emotions –or others that we have pointed out before– 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 illness or worrying about gettingsick.
  • You need to be constantly aware of or hear 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 paralyzed by fear.
  • You are in a state of alert, continuously analyzing 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 at all costs for fear of contagion.
  • You notice an increase in heart rate, rapid breathing, sweating or trembling without good reason.
  • You have difficulty 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 through some forums, alarming images can be transmitted, and over-information given from a negative perspective magnifies the phenomenon which can make you perceive that a greater threat exist than what there is in reality.
  4. Avoid information saturation. Living permanently connected will not make you better informed and, on the contrary, will increase your sense of risk and unnecessary nervousness.
  5. Go to official sources and look for contrasting information from experts: Ministry of Health, Official College of Physicians, World Health Organization, other official organizations, etc.
  6. Compare 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 Department of Health, 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 an adaptive attitude for each situation.
  12. Try to make life as normal as possible and continue with your usual routine, within the situation in which you find yourself. In areas where you cannot keep up, reorganize your schedule.
  13. Beware of 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, 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 preventive measures 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 feelings of fear or apprehension about 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 real risk. Be cautious and prudent without being over- reactive, knowing that sometimes we can also exaggerate to relieve and protect ourselves from what frightens us.
  5. Don’t take actions that may compromise your wellbeing, pretending to feel unrealistic invulnerability. Avoid what encourage addictive behaviors.
  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 disease:

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 possible ahead of time.
  2. Don’t be unnecessarily worried. Be realistic: most people seem to be getting well.
  3. When you feel afraid, rely on the experiences you have had in similar situations. You may not associate with it now because you have a more serious issue at hand but it will show you how you have successfully overcome many difficult illnesses or circumstances in your life.

Annex 2: Relaxation Exercises

Here are three types of exercises that can be useful if you think you need a space to relax. There are different variants and different modalities. To some people they help to promote emotional balance, so we suggest them. However, you may find benefits in different techniques. If you think that these do not help or satisfy you, feel free to find what is best for you.

Breathing control

It is not difficult to imagine that throughout the quarantine you may experience some feelings of anxiety. One of its symptoms is shallow breathing. We offer you a simple technique that you can practice anywhere: breathing control.

  1. Breathe in through your nose instead of your mouth.
  2. Breathe softly and deeply several times.
  3. Notice how the abdomen widens when you inhale and how it narrows when you exhale.
  4. Take a couple of deep breaths in through your nose and exhale slowly, and gently through your mouth.

Diaphragmatic breathing

This technique needs a little more training and a quiet place to concentrate to do it well.

  1. Get into a comfortable position and try to relax your muscles.
  2. Place one hand on the chest and one on the abdomen.
  3. Take a slow breath in through your nose, taking it to the hand on your abdomen. The chest hand should be immobile.
  4. When you can get the air there, hold it for a couple of seconds.
  5. Release the air little by little through the mouth, so that you feel the abdomensinking while the hand of the chest remains immobile.
  6. Repeat this exercise several times.

Visualization

This exercise combines relaxation techniques with meditation techniques.

  1. Find a comfortable place where you won’t be interrupted.
  2. Light the place up in a soft and pleasant way that is pleasing to you.
  3. Put on relaxing music at a low volume, enough so that you can listen to it, but it does not bother or distract you.
  4. Close your eyes and focus on your breathing. Feel the air enter your nose and exit your mouth.
  5. Think of a blue sky. Perceive the energy that the sun gives you and focus your attention on the feeling that type of day would provoke in 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 that vision and focus on the feelings it arouses within you.
  9. You will be more relaxed each time you do it. When you succeed, visualize yourself, in that landscape, lying on the grass or in the sand on 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 in the landscape and begin to stretch the muscles of your body, little by little and without opening your eyes.
  12. As you stretch, become aware again of the music that surrounds you. And when you’re ready, open your eyes slowly, and calmly.

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