How to Combat the Stress of Isolation through the GRAPES Approach to Self Care

This has been a hard morning.  I woke up with a headache after a night of fitful sleep and bad dreams.  Everything seems to be going wrong.  A good friend of mine is moving away.  My job is changing in ways that make me question whether it continues to be a viable way for me to make a living, and my apartment seems to get smaller and lonelier every day.

COVID-19 quarantine is exhausting, and yet I have grave concerns about the possible health ramifications of re-opening.  There’s an odd push-pull in my heart as to which direction we should go.

Yesterday was a big social day for me by 2020 standards.  I saw two friends and got my first haircut since the pandemic began, which felt AMAZING!

After the haircut, I met my friend, Jessica, at the mall and we had dinner together.  The restaurant was seating people every other table so that there was a lot of space between us.  The waiter wore a mask, so we couldn’t see her face.  She gave us a disposable paper menu and a pencil to mark our orders, and asked us to deposit the menu on a tray at the table next to us instead of taking our orders directly.  It was a strangely isolating dining experience.  After eating, Jessica and I were planning to do some shopping, but we found that the stores were all closed by 7:30pm–a situation we hadn’t been expecting.

When I got home, I felt depleted, and went to bed early even though I had things that I’d planned to accomplish before sleeping–like writing this blog post!  It was exciting to go out into the world again after months of quarantine, and yet the world’s jarring strangeness made me sad.

As I lay in bed wanting to sleep, but too overwhelmed to do so, I started thinking about the nature of isolation.

We’ve been sheltering in place for months for the health of the community for months, but isolation is so difficult and painful for human beings that it is often used as punishment.  

  • Children are sent to their rooms or to time out when they have misbehaved.
  • People get banished when their behavior is so poor that the community can’t tolerate them anymore.
  • Inmates are placed in solitary confinement when they act out.

I think that this isolation has felt a lot like punishment for many, which explains some of the weird ways in which people have reacted.

Isolation can lead to depression and anxiety, which can lead to more depression and anxiety in a self-sustaining feedback loop.  In this climate of fear, many people have developed varying degrees of agoraphobia–the fear of leaving the house–and with good reason.

However, depression and anxiety aren’t the only possible negative effects of isolation.  There are serious physical health problems caused by isolation as well.  

According to the article, “Social Isolation Negatively Affects Mental and Physical Health–Here’s What You Can Do to Stay Healthy,” by Kelly Burch, social isolation can lead to cognitive decline, heart problems and a weakened immune system.  It can also cause a 30% increase in the risk of coronary artery disease and stroke.  

Social isolation negatively affects mental and physical health — here’s what you can do to stay healthy by Kelly Burch

The culprit here is stress.  When people are stressed, their bodies secrete adrenaline and cortisol, hormones that tell their nervous systems that they are in danger.  The nervous system then tries to save the body by telling it to run, fight or freeze.  This is a completely involuntary reaction, like breathing.  If we were being chased by lions, this response would probably save our lives, and then when we were safe again, our bodies would go back to normal.

However, in the case of isolation, there isn’t any physical threat to run from, so the stress never dissipates, and our bodies constantly think that we’re in danger, keeping us flooded with fight or flight hormones.

It’s not too difficult to understand why a constant state of fight or flight could lead to anxiety.  It’s a little more complicated, though, with physical damage to body.  In essence, what happens is that our bodies conserve the energy that they would be spending on repairs to our heart walls or stomach linings in a relaxed state, and spend that energy instead on the fight, flight, freeze response.  So if we’re in a constant state of fight, flight or freeze, our bodies never do necessary minor repairs, leading to extensive damage over time.

For this reason, it’s extremely important to do things every day to lower your stress level.

I highly recommend using a structured approach to self care in order to intentionally make deposits into your own emotional bank account.  Otherwise, it’s much too easy to become depleted, which leads to increased stress.  The structure that I like to use is known as GRAPES, which is an acronym for:

G – Gentle to self

R – Relaxation

A – Accomplishments

P – Pleasure

E – Exercise

S – Social

By getting a little bit from each category of self care into your day, you’re well on your way to inoculating yourself against stressors such as isolation.

Gentle to self means doing things to treat yourself kindly.  A great resource for self kindness is Kristin Neff’s work on self compassion. Kristin Neff’s Self Compassion Website.  Other great ways to be gentle to self include meditation, rest, taking a bubble bath, and avoiding sources of negativity–such as the news.

Relaxation is a self care component that many Americans feel guilty allowing themselves.  In American culture the emphasis is on doing instead of being, but the act of being is an extremely important part of self care.  If you examine your daily activities and find that you’re short on relaxation, I give you permission to take more time for leisure.  It’s not laziness.  Rest time is time when our bodies are calm enough to do those little repairs that we need for optimal physical health.  So, please, take naps.  Listen to beautiful music.  Lay in a hammock.  It’s good for you.

Accomplishments are important too, of course.  We all need to feel that we have purpose in our lives.  Without purpose, humans tend to fall into a terrible state of meaninglessness.  However, it’s important to know that accomplishing things doesn’t necessarily mean going to work.  It can mean completing a creative project, or cooking a wonderful meal, or practicing a new skill.  Do your best to make your accomplishments meaningful and life-affirming for you.

Pleasure is an extremely underrated component of self care.  It seems to me that America’s Puritan heritage has led to a mistrust of pleasure as somehow inappropriate.  However, pleasure is good for you.  It makes people happy, and releases oxytocin and opiates, the feel good hormones.  We need happiness.  Without it life is bleak.  So do things that feel good to you.  They are important and meaningful.  Dance.  Laugh.  Hug.  Eat delicious food.  Get a massage.  Sit in the sun.  Surround yourself with beautiful smells.

Exercise is the single most effective thing you can do to increase your happiness.  This is no exaggeration.  Scientific studies have shown that 30 minutes of cardio daily is equal to, or even more effective, than an antidepressant in improving mood.  This doesn’t necessarily mean that you need to go out and get a gym membership and start lifting weights and running on treadmills, although that’s a great option if you enjoy that.  I recommend finding your fun as the best way to create an exercise regimen that’s sustainable.  If it’s fun, you’ll keep doing it.  If it’s not, it just feels like a chore.  So, if you enjoy dancing, then dance.  If you enjoy being outside, maybe you should take up hiking or walking in the park.  If you enjoy mindful movement, then maybe meditation or Tai Chi or for you.

Social is a tough one right now.  Things are starting to open up a little bit as we move to the next phase of the COVID-19 pandemic, but life is still a sea of face masks and closed businesses.  I really miss hugs.  However, you still can get your social self care in doing small things like taking a walk and waving at people that pass.  (Yes. I’m that weirdo, and you can be too).  Meeting friends in open-air settings is good too.  There are many ways to see people virtually, and I think that they can be helpful in moderation, but I also think that they can be confusing to our nervous systems if over-used.  They create a cognitive dissonance.  Our minds think that we saw someone, but our bodies didn’t get any energy or pheromones and feel just as isolated as they did before the Zoom meeting or FaceTime call.  Still, seeing people’s faces via computer screens is better than not seeing them at all.

A great way to take care of yourself, and to combat the stress of isolation, is to make a plan each day for how you’re going to get a little taste of each self care component above.    Both your mental and physical health will thank you.

One last thought.  Taking care of yourself is not selfishness.  Many people have been brought up to believe that it is.  However, I submit to you that the best gift that you can give to others is a happy and well-cared-for self.  When you feel good, you’re more pleasant to be around, and you have more energy to give to others.  By being open-hearted to yourself, you’ll be better equipped to be open-hearted to others.  And besides, you’re totally worth it, just because you’re you.




In Praise of Interdependence

For the past 3 weeks I’ve been working from home because of the COVID-19 quarantine situation.  For the first week, I was elated.  I slept late, worked in my yoga pants, and did little projects around the house between patient phone calls.  During the second week, I was less excited about it, but I was OK.  Then, the third week came, and the loneliness and isolation of three weeks by myself in my one-bedroom apartment hit me hard.  Like a caged tiger, I’ve been pacing around my living room, and peering through the black wrought iron of my security gate out into the quad outside my front door.

So, when my friend, Jeannine, contacted me yesterday and asked me to come over to her place for a social distancing dinner in her backyard, I was so excited I could barely contain myself.  When I got to her place, I had to swallow my need to hug both Jeannine and her husband, Paul.  Everything seemed hilarious.  When the chicken that Paul was barbecuing caught on fire and he couldn’t figure out how to rescue it, I laughed myself silly.  It didn’t matter to me that I might not have anything to eat.  I’d figure that out.  (The chicken ended up being perfectly cooked, by the way).  When we played Mexican Train, I felt nothing but joy and camaraderie, even though I lost miserably all three times.

It got me thinking about the value of community.  There’s a strange push-pull in American culture about needing others.  We definitely have a hero complex.  All you have to do is check out our film-making choices to see it.  How many incarnations of the strong and exceptional person saves the world alone are even possible?  I’ve grown to hate these hero movies.  They set up unrealistic expectations of self-reliance, fearlessness, and invulnerability.

On the other hand, American culture is one of the most extroverted cultures on earth.  Being highly social, overtly friendly, and always having something to say, are highly prized American personality traits.  As a Highly Sensitive Person, who needs alone time to re-charge, enjoys solo creative projects, and freezes around inauthentic people, I’ve felt defective for most of my life.  Telling myself that my need for solitude, my inability to come up with interesting things to say in large groups of people, and my lack of an emotional filter were weird, I’ve spent a lot of time pretending.  It’s only within the past year or so that I’ve realized that being wired this way is OK, and I’ve given myself permission to be my authentic self.  What a relief!

With pressure to be highly social and friendly, but also be a fearless lone savior, I think we’re all a little confused about how much community is the right amount.  I’m constantly struck by how many people tell me that they feel like they should be OK with being alone, and that the deep need that they feel to belong is wrong somehow.  They tell me that it’s a sign of codependence, and that they need to work on their unhealthy coping strategy of being with others to avoid feelings of loneliness.  Usually this comes up while the person is grieving the loss of a loved one.  Three weeks into grieving, people believe that they should be over it already.

This mindset never fails to sadden me.  What a sorry state of affairs to believe, as a society, that needing people is a sign of mental illness.   How terrible to think that grieving is somehow a weakness.  I explain to these people that codependence doesn’t mean what they think it means.  I tell them that codependence is actually a description of people that put their own needs aside in order to support others in an unhealthy and self destructive way.  I’m not talking about self-sacrifice for the greater good.  I’m talking about harming oneself because of an inability to set or respect boundaries.  Codependence is the person in a domestically violent relationship who doesn’t leave and makes excuses for the partner’s behavior.  It’s the spouse of the alcoholic who constantly cleans up horrible alcohol-induced messes, pays DUI fines, and apologizes to friends who have been subjected to drunken rages.

Needing love, community and support is completely normal and healthy.  We’ve evolved over millennia as tribal creatures.  Some of us need smaller tribes than others, but we all have a need to belong, to be understood, and to be loved, and that is a good thing.  Society would fall apart if humans didn’t naturally organize themselves into communal groups.  Where would we be if someone didn’t grow crops and share them with the rest of us?  What would happen if nobody cared for the sick, or educated our children?  It would be a much poorer life, indeed, if we weren’t the interdependent creatures that we are.

Interdependence is the exact opposite of codependence.  When we’re interdependent, we help, support, and care for the people around us, just as they help, support, and care for us in return.  Nobody is harmed in this reciprocal relationship, and everyone’s lives are enriched.  Interdependent relationships are a sign of mental and emotional health.  In order to have them, we have to be able to set the boundaries of what is OK and not OK in how we treat each other.  We also need to be able to respect those boundaries when they are set.  This type of relationship takes maturity, kindness, and compassion, and it is one of the most beautiful pieces of the great jigsaw puzzle of what makes us human.

One of my favorite things about the modern world is the web of global interdependence that allows me to buy goods from across the globe and have them in my home in a couple of days.  I love that I can tap into recordings that were made in Russia or India at the touch of a button, or that I can get on a plane and be in Italy in less than a day.  If I want to, I can buy a book written in another language, and then translated into my own, and absorb the ideas of another culture and another mind.  The more that we share ideas with each other, the more we understand each other, and the more that we see how much we are the same as humans no matter where we were born or which language we speak.

I know that my pacing loneliness is a result of a breakdown in interdependence.  I also know that toilet paper shortages, and the fact that I had to buy flour and yeast on, because I couldn’t find it anywhere else, in order to make the bread that is currently rising in my kitchen, is a result of a breakdown in interdependence.  I fear anything that threatens interdependence and understanding between humans, such as walls between nations, isolationism, or nationalism.

While I understand that sometimes we have to be alone to protect ourselves, to lick our wounds, and to heal, my hope is that these times of isolation are brief, and that we don’t end up as a world full of angsty teenagers hiding in their bedrooms playing video games with “keep out” signs on the door. When the danger of COVID-19 is passed, my hope for the world is that we will be brave enough to re-open to each other as a world full of humans who struggled together through something terrifying. I hope that we can be united in the knowledge that nobody is to blame for it because sometimes shitty things just happen because life is hard.  And yet, it is the hardest times that can hone us into the best humans if we are able to give the experience meaning.  May the meaning be love, kindness, compassion and community.

Below are some links for information about codependence and interdependence.  Two wonderful books about overcoming codependence are Codependent No More by Melody Beattie, and Facing Codependence by Pia Mellody.  Pia Mellody’s book was the first book I ever read about codependence, and it opened up a whole new way of thinking about healthy relationships for me.

Ten Articles About Codependence

How to Build a Relationship Built on Interdependence