My own roots are many, but the largest portion by far is Asturian, a people from northern Spain. Asturians have immigrated to this land for centuries, often driven by poverty and hunger. Perhaps the largest wave of immigration occurred in the late 1800s and early 1900s, when my grandparents arrived. Many of them came to work in the zinc smelting industry, in our coal mines, or in the cigar factories of Florida.

Asturian American immigrants living in West Virginia in the 1920s.

In their early years in the US, these Asturian immigrants experienced a great deal of racism and classism. In the West Virginia town where my Asturian grandparents settled, the KKK burned crosses to intimidate southern European immigrants, including Spaniards, Italians, and Hungarians. Local leaders, even the grade school principal, conspired to keep their immigrant neighbors disempowered.

This prejudice was due to skin color, anti-Catholic sentiment, and discomfort with people who work with their hands, eat different foods, and speak a different language.

Prejudice against Spaniards occurred throughout the United States. Poor Spaniards who were hired to work on Hawaiian sugar plantations in the early 1900s were transported from Spain in what have been described as "slave ships." Many of those immigrants left Hawaii complaining of extremely brutal working conditions. Between 1915 and 1919, hundreds--possibly thousands--of Spanish-speaking residents in Texas were indiscriminately killed by the Texas Rangers. This 1949 sign posted in Texas shows that the prejudice continued for many years.

Whites only sign 1949 Texas
A sign from Texas in 1949. We serve Whites only, no Spanish or Mexicans.

I don't want to suggest that Asturians faced the same ferocity of prejudice that Blacks have faced for hundreds of years. The extent of disrespect and utter violence that Black Americans have experienced is much greater.

And maybe your family didn't suffer under Jim Crow, but it may have suffered under "Juan Crow" or the many other forms of racism and classism in America.

Did your parents or grandparents teach you to speak their language? Did your family change the spelling of its last name? Have you wondered why so many children of immigrants turned their backs on their heritage in order to blend in? Very likely, it was to escape prejudice.

No one in the Land of the Free should suffer physical, mental, and economic abuse.

We are all one, all human. We deserve equal treatment socially, economically, and politically. We're so much stronger when we value the contributions, perspectives, and humanity of all.

Remembering that our own families have been targeted by racism and classism, may we reject any such hatred or fear that targets anyone. May we all breathe freely.

References
https://AsturianUS.org/forum/
https://www.amazon.com/PINNICK-KINNICK-HILL-AMERICAN-STORY/dp/1933202149
https://www.texasstandard.org/stories/texas-exhibit-refuses-to-forget-one-of-the-worst-periods-of-state-sanctioned-violence/
https://tracesofspainintheus.org/hi/recortesclippings/

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I would be surprised if you haven't noticed an increase in often difficult to explain emotions since the start of the coronavirus pandemic.

Have you noticed yourself and others:

  • acting as if nothing has changed
  • being more anxious or agitated
  • becoming angry more easily,
  • crying more often,
  • isolating from others,
  • driving faster,
  • behaving more generously, or
  • hoarding?

This shift toward more emotional behavior may be grief, a natural response to overwhelming events and great loss.

Grief generally includes a set of fluctuating stages, but they don't typically appear in a neat sequence. Grief can be messy.

There are several ways of framing the stages of grief. One seven stage model includes:

  • shock and denial;
  • pain and guilt;
  • anger and bargaining;
  • depression, reflection, and loneliness;
  • an upward turn with less intense uncomfortable symptoms;
  • reconstruction and working through solutions; and
  • acceptance and hope.

What is especially unusual is that we've seen this wave of grief overtake people all around the globe as the coronavirus has spread. This grief is affecting people of all ages in all nations. We're not alone.

I hope that you, too, will find this article by Scott Berinato in the Harvard Business Review helpful and even encouraging.
https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief?fbclid=IwAR1_XlhY8iPrf2QJPvmT9R1D4pBlVbzFJd90RMGgWYU8W-WJaAtLyKxyjaA

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Each of us will decide when we feel confident enough to begin in-person contact with others. Like many, psychotherapists must weigh the risk to their clients, families, and themselves.

As you consider this question for yourself, the article in the link below will be very useful:
https://erinbromage.wixsite.com/covid19/post/the-risks-know-them-avoid-them.

In his article, Erin Bromage has given a sobering, detailed analysis of the primary ways that people have gotten infected. Some of the main behavioral sources of transmission are toilet flushes, sneezing, coughing, yelling, speaking, and simply breathing. As most are aware and Bromage notes, actions such as touching contaminated surfaces and then touching your face can also transmit the virus.

The most common locations for the transfer of the virus have been in private homes, prisons, religious ceremonies, choirs, indoor sports facilities, and workplaces. Restaurants, parties, and funerals have also been high-risk settings. Curiously, Bromage did not mention hospitals, nursing homes, doctors' offices, and other health care facilities.

Basically, as the work closures are loosened, and we start to venture out more, possibly even resuming in-office activities, you need to look at your environment and make judgments. How many people are here, how much airflow is there around me, and how long will I be in this environment. If you are in an open floor-plan office, you really need critically assess the risk (volume, people, and airflow). If you are in a job that requires face-to-face talking or even worse, yelling, you need to assess the risk.

https://erinbromage.wixsite.com/covid19/post/the-risks-know-them-avoid-them

There is a lot we do not know yet, but it is clear that the risk of contracting COVID-19 will be on-going. For many of my clients and their families, this risk could be life-ending.

I do not believe we will be able to meet safely in an enclosed office for many more months.

It is possible that some therapists will opt for providing talk therapy in outdoor sessions, such as while walking in a park. I will be considering the use of outdoor sessions, although that would require additional safeguards for safety and privacy.

The good news is that teletherapy via video-conferencing is possible and works very well with most forms of psychotherapy. I will continue offering teletherapy.

Neurofeedback conducted in the office with both therapist and client present will likely be impossible for an extended period of time. Clients who wish to purchase or rent a neurofeedback system will be able to do neurofeedback in their own homes with my supervision via video conferencing.

I hope that you and your family are safe and remain healthy. If you, like many of us, have lost family members to COVID-19, I am deeply sorry for your loss. If you have suffered with COVID-19, my heart goes out to you and I wish you a speedy and full recovery.

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I've been thinking this past week about how a large-scale infectious disease outbreak, such as appears likely with our current Coronavirus, might affect psychotherapists' private practices.

I've been surprised by how many clients come into my office with sniffles and worse. It is cold and flu season, but now many clients nervously mention their sniffles and some are much more careful to not infect others in the office.

It strikes me that teletherapy would be fine for most (70%) of the work I do. Getting ready now to provide teletherapy may make sense.

There are a number of articles about how the general population can prepare for the increase in COVID-19 cases, such as this article: https://www.nytimes.com/article/prepare-for-coronavirus.html.

Synthesizing what I've read, here are what I'm seeing as the key points for private practice folks:

  • Wash your hands with soap and water frequently. You can use hand sanitizer if your hands aren't dirty.
  • Cover your nose and mouth when you cough or sneeze with the crook of your arm.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • If you are sick, stay home unless you are leaving to see a medical doctor.
  • Get a flu shot, if you haven't already.
  • You may not want to use face masks unless you are already sick, have a compromised immune system, or are in regular contact with sick people.  (Good quality masks appear to now be very expensive and in short supply.)
  • Keep at a distance from sick people. (The safe distance is often described as 3 to 6 feet, which is how far large droplets travel. This article -- https://universityhealthnews.com/daily/eyes-ears-nose-throat/how-far-does-a-sneeze-travel/ -- suggests that fine droplets may travel 19 to 26 feet, or even 200 feet, and at great speed. So, the advice to stand away from sick people may not be realistic.)
  • Prepare a plan and communicate it to your clients.
  • Stock up on any supplies your business might need in the event that shopping or supply chains are interrupted. (This may also apply to essential food and water. Already, an office device I had ordered is on indefinite delay because COVID-19 has caused manufacturing and supply problems in China. Face masks, hand sanitizer, and toilet paper may also be in short supply.)
  • Realize that only about 2% of people who catch COVID-19 die, but be especially careful if you or any your clients likely have weakened immune systems.

I'm very aware that a post like this could be viewed as fear-mongering. That's not my intention. Our goal should be to be able to offer ongoing psychotherapy services while also doing what we can to help our clients and ourselves remain healthy.

Please send me an email if you have comments or additional suggestions!

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We are designed to feel anxiety. Anxiety is protective because it helps us survive by warning us of dangers.

Everyone experiences anxiety, although some of us get so anxious that we wonder if we can handle it. And sometimes our anxiety may be unreliable, giving us false alerts.

Luckily, there are a number of relatively simple, effective, and inexpensive ways to deal with anxiety. ...continue reading

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