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The 180 Podcast Mar 18, 2020

Coronavirus: Keeping Our Children And Ourselves Safe, With Pamela Cantor, M.D.

In this special edition of The 180 Podcast on the coronavirus, host Chris Riback talks with Pamela Cantor, M.D., Turnaround for Children’s Founder and Senior Science Advisor, about how to address the fear, stress and disruption caused by the pandemic.

A new strain of coronavirus has created a global crisis. Humans never encountered this strain until just a few months ago, so don’t have immunity or protective factors against it as with viruses that have been around a long time. There is no vaccine and no medications to treat it, yet. It is also highly contagious and can lead to death, especially among the elderly and those with underlying health conditions. The virus is already straining the capacity of governments and health care systems to confront it. Schools, businesses and borders are closed, and global financial markets are reeling.

Americans are being told to stay home in order to be safe. But to provide physical safety, means disruption of the very things that produce emotional safety, namely the human connections everyone needs to feel secure, cope with stress, manage fear, and surmount this crisis. School and college-aged students are being separated from their teachers and friends, a sudden disruption made more acute because so many students depend on their schools for food, health care, and adults they trust.

The massive change in the way Americans live, learn and work is the biggest problem for young people today and the adults surrounding and supporting them. So the engineering problem becomes how to create both physical AND emotional safety at the same time for all children.

During this special edition of The 180, Dr. Cantor offers insights and advice on how we can help children and the people who love and care for them weather this unprecedented emergency.

To supplement the insights and advice offered by Dr. Cantor on this episode, Turnaround has created a coronavirus pandemic resource page.

Clips

#1 — Coronavirus: 6 Tips for Parents

The coronavirus is producing a lot of anxiety, stress and worry for everyone. What happens to our bodies when we are under stress? How can parents restore a sense of safety for their children in such trying times? Here are 6 tips from Dr. Cantor.

#2 — Coronavirus: Signs of Children Under Stress

There are signs that children are under stress that everyone can learn to recognize. But children respond to stress in different ways depending on their individual histories. Here’s what to look for according to Dr. Cantor.

#3 — Coronavirus: Finding a Vaccination for Stress

Life as we know it has been upended; schools, churches, theaters, stadiums and businesses closed. Children miss their teachers and their peers and their normal routines. So how are we going to create new ways for young people to be safe, safe physically to be sure, but also emotionally during such stressful times? How can children help? Here are some ideas from Dr. Cantor.

#4 — Coronavirus: Do the Right Thing

We know we are supposed to practice social distancing and scrupulous hygiene to protect ourselves and others from coronavirus. But knowing what’s right and doing the right thing are not the same, especially when it comes to children. Dr. Cantor explains why.

#5 — Coronavirus: Restoring a Child’s Sense of Safety

How to help children know that one day, they and we will be okay again. There are several ways, says Dr. Cantor.

#6 — Coronavirus: Our North Star

Everyone has a super power to help children through this crisis, says Dr. Cantor. We have to look to our North Star.

 

Complete Transcript

Chris Riback: I’m Chris Riback. This is a special edition of the 180 Podcast. Coronavirus: Keeping our Children and Ourselves Safe, with Dr. Pamela Cantor. Pam, thank you for joining me for this special edition on the coronavirus. It’s a very unsettling, stressful time for all of us, which is why we thought it would be a good idea to have this conversation. Fortunately for us, you have expertise that I think will be especially helpful for our listeners. You’re a physician, a child psychiatrist who specialized in trauma, and you’re the founder of Turnaround for Children, an organization which was actually founded in the wake of September 11th. So you bring years of experience in medicine, helping children and working with schools on how to cope with the kinds of fears that envelop us during times like this.

Chris Riback: During this conversation, I’m hoping you might be able to offer insights and advice on how we can help children and the people who love and care for them weather this pandemic.

Dr. Pamela Cantor: Thank you, Chris. I too hope this conversation will be helpful, especially for parents, teachers and caregivers who are going to be wondering what they can do to keep themselves and their children safe. Safe, physically to be sure, but also safe emotionally and protected from all the stress and disruption they’ll be experiencing. So physical and emotional safety are the two big subjects we’re going to be talking about. But just as I say this to you, I’m aware that the cornerstone of safety for all of us are the important people in our lives. Yet the advice we’re getting is to distance ourselves from people in order to be safe.

Chris Riback: Yes.

Dr. Pamela Cantor: So what I hope we do in this conversation is draw out how to address these two necessities, necessities that appear to be at odds with each other at the very same time. Physical safety, which requires physical distance. And emotional safety, which requires connection and understanding and empathy.

Chris Riback: So for starters, I’m hoping you can help our audience understand some of the basics about this virus. Demystify it for us if you will. What is coronavirus and how do people get it?

Dr. Pamela Cantor: So the first thing to know about the coronavirus is that this particular strain is new. Humans never encountered this strain until a few months ago. So we don’t have immunity or protective factors against it the way we do with other viruses that have been around for a long time and we don’t yet have a vaccine against it and probably won’t for at least a year and we don’t have medications to treat this virus yet. Likely, those are going to emerge in the next year or so, but for now, the most important thing we can do is to prevent ourselves and others from getting it. And if we do get it, to put ourselves under optimal conditions to recover from it and not give it to anyone else.

Dr. Pamela Cantor: Another important thing to know is the coronavirus is very contagious. So if a person with the virus coughs or sneezes, droplets containing the virus will travel, landing on surfaces where it can stay infectious for days or infecting people nearby when it enters the body through the nose, the mouth, or the eyes. This is why there are so many recommendations now for reducing our contact with large numbers of people and for scrupulous personal hygiene.

Chris Riback: So how does it make people sick and are certain people more at risk than others?

Dr. Pamela Cantor:When the virus enters the body, it attaches to the cells in our airways infecting them. And then like all viruses, it makes copies of itself. Many, many copies. Those viruses then infect other cells nearby or end up in the droplets we release when we cough or sneeze. When the body realizes that it has the virus, it marshals the immune system to fight it. And one of the ways it does this is with a fever which we are seeing in many people who have the coronavirus.

Dr. Pamela Cantor: But sometimes with this virus, the body’s immune system has a severe reaction and it can attack healthy cells, particularly the cells of the lungs. When this happens, the lungs can fill up with fluid making it hard to breathe. And in the worst cases, this can cause an acute form of respiratory distress that can lead to death. Older people, people who have serious underlying health conditions and people who smoke seem to get the most serious forms of the disease caused by the coronavirus, which is called COVID-19. Others have a milder form with symptoms that include headache, body aches, cough and fever, much like a typical flu. And fortunately, so far as we know, children and teenagers and young adults are not getting the disease as often nor getting as sick when they do get it. They can, however, still spread the disease to others.

Chris Riback: Have we ever seen something like this before?

Dr. Pamela Cantor: The good news is that there is an enormous amount of research into the behavior and life cycle of viruses, including other strains of the coronavirus. So we’re not starting from a blank slate here. There has been huge investment in research, particularly since the discovery of the HIV virus that causes AIDS. That virus taught us a lot about how viruses replicate in the body and sometimes hijack our own immune systems so that it attacks our own cells. We know so much more about viruses today than 30 years ago when I was in med school during the beginning of the AIDS crisis.

Dr. Pamela Cantor: In fact, the person you see on TV every day reporting on the effort to contain the spread of the coronavirus, Dr. Anthony Fauci, was in medical school with me and played an enormous role in understanding the behavior of viruses and how to respond to them. He is credited with many of the discoveries that enabled us to understand, prevent, manage, and now be on the verge of a cure for AIDS. It was incredibly reassuring to me to see him leading this effort on the coronavirus. Nothing should interfere with his leadership and he should be one of the most trusted voices and resources to listeners of this podcast.

Chris Riback: Indeed, he’s been just incredible throughout the whole thing. Now, I know we’re hearing a lot about this these days, but help us understand, is it easy or hard to contract the virus? I think it’s worth reminding everyone, what are the best ways to protect yourself and your children from coronavirus?

Dr. Pamela Cantor: Until we have a way to treat the virus or a vaccine to prevent us from getting it, we have to achieve two primary things in order to be safe. We have to achieve physical safety through prevention, which means physical distance, and we need an approach to treatment that buys us the time to recover naturally from this high risk without the benefit of a medication. So let’s take prevention first. When we know how something gets transmitted, in this case, coughing, sneezing, close contact, that tells us what to do to prevent ourselves from catching it or giving it.

Dr. Pamela Cantor: First, personal care and hygiene is crucial. Wash hands frequently with soap or alcohol-based sanitizers for 20 seconds, cover your mouth with the crook of your arm when you sneeze of cough, wipe a child’s mouth or nose when they sneeze or cough, refrain from touching your face and do the things our doctors always tell us is good for our health: eat a healthy diet, exercise, get plenty of sleep. For children nine to 12 years old, this means nine to 12 hours a night and for teenagers, eight to 10 hours a night. Second, reduce the time you spend with large groups of people. This is what’s meant by social distancing, which means don’t go to places that are likely to attract big groups of people. Hang out with people you know and whose approach to hygiene is cautious. Avoid shaking hands, hugging. Instead, do an elbow bump.

Chris Riback: And for any of our older viewers, maybe Star Trek fans, something like a Vulcan salute, like the kind Spock does. I know it means live long and prosper friends on the TV show, but maybe that will come back into fashion, Pam.

Dr. Pamela Cantor: It sounds like it.

Chris Riback: Yes. Okay, we’ll see.

Dr. Pamela Cantor: And third, perhaps the most obvious, keep yourself and your children away from people who appear to be sick and call your physician if you have a temperature of 101 or above and some of the other common symptoms including cough, sore throat and body aches. If you develop these early symptoms, it is important to be tested and after a slow start, more and more safe testing sites are becoming available.

Dr. Pamela Cantor: If you test positive, the plan should be to self-quarantine for 14 days away from any other people.

Chris Riback: One of the things, Pam, I’m hearing is that not everyone is taking this seriously and doing what they need to do to protect themselves and others. We’ve seen pictures of that. Why? Why don’t people just do what they need to do?

Dr. Pamela Cantor: Chris, there is something called the intention behavior gap, which means that 50% of the time, we don’t do the right thing even though we know it is the right thing to do. Now, this is a pretty dangerous thing today when you think about the virus and the risks. So we have to increase the likelihood that more of us do the right thing. Sometimes it’s useful to use a prompt that failing to do it will hurt someone you love or doing the right thing will produce a clear benefit to somebody that you care about, something that will help them. But whatever we do, we have to increase that percentage dramatically today.

Chris Riback: Is the intention behavior gap, which you say is about 50% of the time, is it greater among children? Does that run greater among children than it does with adults? Is it harder to encourage children to make sure to do the things they’re supposed to do or it doesn’t matter adult or child, that intention behavior gap is pretty consistent?

Dr. Pamela Cantor: I think it’s reasonable to conclude that you have to understand something about cause and effect to even understand the meaning of the intention behavior gap and to address it. So with very young children, some of the prompts might not be as useful, but this gap exists in adults and it exists in young people.

Chris Riback: Are there any tips that you can give parents? I know it’s one of the things I’m struggling with is the balance. How do I give the instruction to my kids? How does anyone do this that this really is something that you need to do without crossing the line? And, “inducing panic” might be strong, but making them more anxious than they should be. My goal, of course, all of our goal, is to generate positive behavior without increasing any type of anxiety. Any tips on how parents might do that?

Dr. Pamela Cantor: One of the things that I often think about is that kids are wiser and smarter than we often give them credit for being, and we’re often telling them what to do. Very often, if you explain the facts to a young person and you ask their advice on how to handle this, you let them tell you what is difficult in taking this advice or doing this, very often, what you’ll arrive at is something that is genuinely helpful to them in being able to do the right thing. I think that just telling kids to do something, for some kids, maybe that works, but very often with young people, what you need to do is engage them in understanding why you’re telling them what you’re telling them, what its purpose is, and even getting their advice on what to do.

Chris Riback: Tell me what that would sound like. So if you are talking right now to the seven year old Chris or the 10 year old Chris, what would that sound like?

Dr. Pamela Cantor: If I were talking to the seven year old Chris, I would start with, “Here’s what we’re all going to do in the family now.” This is a change. I would explain the basic facts of what’s going on. Not to alarm them, but just to liken it to when somebody in the family has a cold or a flu and the kinds of precautions that we take. I would try to normalize it. I wouldn’t try to say that somehow or other this is a plague that is affecting us and that’s why we have to do these things. These things are good things to do all the time.

Dr. Pamela Cantor: I would see if they have any questions. I would model it for them. I would prompt them because very often seven year-olds are going to forget. Just assume that this is going to take prompting. There could be incentives for hand-washing. You could put an hourglass that is timed to 20 seconds in a bathroom and have the kids use it as a way of guiding hand-washing. I think with the seven year-old, you really want to lay out the expectation, model it, and then know that you’re going to have to prompt a child ongoing if they’re in that age group.

Dr. Pamela Cantor: The 10 year-old, the teenager, is very different because teenagers have will and intention and agency. I think they need more facts about what’s really going on and what the potential risks and consequences are to them. Then I think with 10 year-olds and teenagers, you have to ask their advice in how best to manage this. If they have siblings, little siblings, engage them in helping a younger sibling to do the right thing. But I think this is a moment where a family has to come together and band together as a unit in order to be able to do things that are healthy and keep everybody safe. They need to. It would be a good thing for them to feel a sense of responsibility to one another. That can’t be bad for kids.

Chris Riback: If I’m a parent who is nervous or anxious because I watch the news, I read the papers, I see what’s coming across social feeds and I’m nervous. All of a sudden I realize that my kid, maybe this is the seven-year-old kid or the five-year-old kid, didn’t wash his hands, didn’t wash her hands, forgot to do it, didn’t do it today. I fully assume that my reaction is supposed to not be to get angry.

Dr. Pamela Cantor: Not only wouldn’t I do that because all your anger will inspire is hurt and a sense of failure that they’ve let you down, they’ve disappointed you. Or they’re going to want to retaliate against you and prove that you’re wrong. There’s no point in the anger. What you have to be is patiently persistent so that they know that this isn’t going away anytime soon, that this is a new normal for the family, that we’ve all got to do it and they have to get with the program.

Dr. Pamela Cantor: I think the patient persistence and enlisting them in helping others and in understanding that others are being more impacted even than them. I think all of those things are opportunities for kids to feel a sense of responsibility to someone other than themselves. To care about others, not just themselves. To figure out how to be participants in solving something either with their peers or within the family unit.

Chris Riback: Incredibly helpful. What a great phrase, “patiently persistent,” which seemed to be guidance that could apply to all kinds of parenting but certainly right now in child care. But certainly right now.

Chris Riback: I’d like to move on now to something you said before. You said there is no treatment for coronavirus right now. So what do we do?

Dr. Pamela Cantor: There is no medicine for the virus yet. The way we all recover from a virus is that we rely on our immune system to fight the virus off. This often takes typically about five to seven days. We all know how that feels. We don’t feel great while it’s going on

Dr. Pamela Cantor: What we need to do during that time is to help our immune system do its job. Its job is to manage our symptoms with things like fluids, soups and juices, abundant rest, the use of Tylenol or Advil for a fever and healthy nutrition. We need to keep from infecting anyone else. If we are in a high-risk group, either over 60 or with any underlying medical condition, we must get medical consultation and care right away. People in high-risk groups should be consulting with medical professionals at the first sign of symptoms.

Chris Riback: Like everyone else, I have listened to that advice you are giving the seven and 10 year old and adult just a moment ago. I have been washing my hands more times than I can count over the last week and doing all of the things that you’ve described. It’s helpful to know that physical safety is so important and that we have some control over something right now.

Chris Riback: We talked about this a little bit, but I’d really like to understand even more, the stress of this. Can we prevent that? Can you tell us about the effects of stress? What do we do about our fears, our children’s fears and the stress that this is bringing into all of our lives?

Dr. Pamela Cantor: It’s true, Chris, that this virus is producing a lot of anxiety and stress and worry. This is no small thing. Stress has its own effects on our health and our emotions. We humans have a stress response that is mediated by the hormone cortisol. When we experience stress, that hormone is released and it floods our bodies and our brain. This is the hormone that produces that characteristic feeling of fight, flight and freeze.

Dr. Pamela Cantor: But there is a second hormone that is part of our stress response and that is the hormone oxytocin, which hits the very same structures in the brain as cortisol. This is the hormone that produces feelings of love, trust, and safety. Think about the fact that children derive their sense of safety from the adults in their lives. The hormone oxytocin helps us understand that there is actually a biologic basis for that feeling of safety.

Dr. Pamela Cantor: This means that the most powerful tool that we have to manage stress and to help our young people manage stress is the human relationship. Because relationships that are strong and trustful release the hormone oxytocin and oxytocin can restore a child’s sense of safety.

Dr. Pamela Cantor: Think about a moment with your kids when something bad happened. Think about the first thing your child wanted to know. As they looked at your face, what did they want to know? They wanted to know if you were okay because they know that if you’re okay, they’ll be okay.

Chris Riback: Any tips to parents in terms of how to maintain that cool facade even when we’re kind of anxious and burning up on the inside?

Dr. Pamela Cantor: It’s not going to be easy to be cool today. Young people read adults well. They read their faces and emotions. Before you talk to a young person, prepare yourself. Prepare so that you can be as collected and as confident as you can be. Know what you want to say. But most of all, be truthful and be authentic.

Dr. Pamela Cantor: Second, proactively bring up a discussion of the coronavirus. Don’t wait for your kids to bring it to you so that you know what your kids are feeling right now and can respond to their concerns and their fears truthfully and assure them that you will create ongoing opportunities to talk and connect.

Dr. Pamela Cantor: Third, be honest about being worried. But at the same time, you need to prepare yourself for their questions so you can convey why you believe we will be okay. You need to be convinced. You need to prepare them for the fact that it’s going to take time.

Dr. Pamela Cantor: Fourth, make sure to give young people factual information so that they know what is true from someone they trust, which may be very different from what they’re hearing elsewhere.

Dr. Pamela Cantor: Fifth, communicate often, even daily. Don’t be surprised if you hear the same questions, questions you’ve answered over and over again. Answer them patiently and completely.

Dr. Pamela Cantor: Sixth, remember, you are the most important adult for the young people in your life. Taking care of yourself, including using reflective practices like meditation will help you care for others.

Dr. Pamela Cantor: All of the suggestions and recommendations I make revolve around this single most important biologic fact. The human relationship has the power to relieve stress, promote resilience, and restore a young person’s sense of safety. This needs to be our North Star. This is what every adult should be guided by in their actions with family members and the young people in their lives.

Chris Riback: Pam, can I ask a follow-up on one of the points that you made just a moment to go in that list of kind of incredible tips? Make sure to give young people factual information. The information that’s out there, and this must depend on age, how much do we want or not want kids listening to the news?

Chris Riback: Then what do we do if they’ve heard something that maybe probably they oughtn’t have heard?

Dr. Pamela Cantor: One of the things that’s tremendously important to kids is that they receive information from someone they trust. The source of truthful information about the virus and its impact are things that they should hear first and foremost from you. One of the things that we learned during the 9/11 period is that parents had to regulate the amount of time that children were looking at the television set.

Dr. Pamela Cantor: Because if you remember back to that time, that picture of the airplanes hitting the towers was repeated over and over and over again. From the perspective of dosage and stress response, we have to regulate children’s exposure to some of the frightening kinds of things that are being communicated on television, but without enough context.

Dr. Pamela Cantor: The other thing that is more true today than even was true in the 9/11 period, that is that children get their information other ways. At all ages, they are getting information through Facebook, through Instagram, through all of the digital mechanisms. For this reason and because parents can’t always regulate how much children are getting from the internet, though they should certainly try, this makes it all the more important for parents to regularly communicate with their kids.

Dr. Pamela Cantor: Having a family conversation several times during the week about what’s new, what we’re hearing, what’s positive, what to worry about, all of those things when someone you trust tells them to you, you know why you should believe them. Then when you hear something that’s kind of at odds with that, you know that it might not be true or you can come back to a parent and say, “Is this true,” and get the facts.

Chris Riback: Such an important point. I can tell you my 15-year-old kid several times in the last week has come to me and said friend X just said this via text or whichever digital form he is using at that point. In some cases has told me things, for example, about the school district before I had heard them. In some cases he’s informing me. But other times coming exactly as you said, getting information, but then coming and asking luckily, I guess I’m lucky in this fashion, “Is this true? My friend just said this. Is it true?”

Chris Riback: Which makes me wonder as well, are there characteristic ways that all young people react to stress? Or are the reactions that any of us have unique?

Dr. Pamela Cantor: It’s a very important question and an interesting question, Chris. Actually, it’s both. Children under stress will have disruptions to sleep, concentration, appetite, mood, all of these things happen because of the effects of stress and the hormone cortisol on key structures in the brain. These are called constitutional factors. We all experience them. Adults who work with children should take note of these kinds of things and recognize them for what they are. They are signs of the effects of stress and indicators of a need for support.

Dr. Pamela Cantor: But children make meaning of experiences based on their histories, their cultures. In fact, there are neural mechanisms in the circuits of our brains that store representations of our histories so that when something new happens, these histories will powerfully shape the meaning children ascribe to them. Adults have to be attuned to this in the ways that they speak to children.

Dr. Pamela Cantor: For example, children who have known significant loss, illness, exposure to violence will bring these experiences into the present when something new happens in the way that they respond to things that are happening today and even how they interpret their significance. This is why it’s so important that adults spend as much time listening as talking. Doing that will likely reveal something in the experience and history of a young person that explains the specific stress they are experiencing, the reason for it and produce a much more personal and helpful response in the adult.

Chris Riback: Delivering that helpful response can be so challenging. I know we all know that. I’m struck when you talk about the signs of the effects of stress and indicators of a need of support. Quite often those signs are actions, and please correct me if I’m wrong, are actions that many of us as human beings might react negatively to. A sign of stress from another person might be something that maybe they’re short tempered, maybe they’re doing something that could invoke or provoke a negative response from us.

Chris Riback: But if I’m listening to you right, part of the role for parents, caregivers, people taking care of children is to understand that those actions are actually signs of the effects of stress and indicators of a need for support. Do I have that right?

Dr. Pamela Cantor: You absolutely have that right. This is something that teachers deal with every single day because stress causes kids to be easily triggered. When kids are easily triggered, they act out with behaviors that are often very difficult in a classroom. This is one of the biggest challenges that teachers face. Teachers learn how to deescalate crisis with a student by the way that they talk to them, even if the student is in crisis and is angry. These are skills that adults have to learn in order to work with people under stress.

Chris Riback: So hard and particularly when many of us may be having to learn them a bit on the fly. I mean one hopes that we’ve learned them through the various stages of parenting. But as you’re describing, we’re in a new time and we’re maybe having to learn some of these skills a bit on the fly, which I guess is exactly why you and I are having this conversation right now.

Chris Riback: Talk to me about restoring a sense of safety. Say you’re a parent or a teacher speaking to a child who seems anxious about coronavirus in particular. Let’s be focusing on the crisis at hand. How do you restore a sense of safety?

Dr. Pamela Cantor: There are actually several ways. One is never underestimate the intelligence or capability of a young person to understand the facts. There are really two basic things that children want to know in a crisis. They want to know that you will tell them the truth, that they can believe you. They want to know why you believe they and we will be okay again.

Dr. Pamela Cantor: Here’s what I’d say about the first. Children need to know that this virus is one that is very, very contagious and that lots of people will catch it. They need to know that they likely will not become sick because of it. If they do, that it will be mild. But more importantly, it goes back to something we were talking about earlier, children need to understand this intention behavior gap. Because even if you don’t get sick yourself, you might not understand how important it is that you protect others and how to do that.

Dr. Pamela Cantor: Adults can provide reasons to do the right thing. You can talk about a person in their life that they’d never want to see sick, including you. You can encourage them to take agency and leadership with friends and explain the truth to their peers. You can ask their advice on how to get more people to do the right thing so that we can prevent the spread of this virus.

Chris Riback: Kids also want to know if things will ever be the same again, right?

Dr. Pamela Cantor: Right. That is the second point I wanted to make about restoring a sense of safety.

Chris Riback: Yes, please.

Dr. Pamela Cantor: Because children really do worry about whether and when we will be okay again. It’s really important to reassure children on this. To do that, they need real facts. We are going to be okay again as a people, as a country. And here’s why. We know more than ever before about the behavior of viruses and what to do about them. And we even know a lot about this virus already. It might take as much as a year, but there will be vaccines and there will be medications against this virus, but what do we do now?

Chris Riback: Yes.

Dr. Pamela Cantor: This is the key question for us. The things that are happening now that are disrupting all of our lives, things like the closing of schools, working from home, no sports or big gatherings, all of these things are things we have to do because our most powerful weapon against the virus is to prevent the spread of it and to be absolutely sure that the people who contract the illness will get the care that they need to recover. Today, this is our most important job, while the scientists do their job to build vaccines and medicines.

Chris Riback: Pam, you just hit on one of the big headlines over the last days. School closings. Can you say more about that? There are many schools and colleges closing, we all know, and perhaps most notably the largest school district in the country, New York City is now closed until April 20th at least. How do these disruptions impact the sense of safety that children need?

Dr. Pamela Cantor: Well, right here is this incredible paradox and it truly is the biggest challenge we face with this virus. All of the actions we are taking today are disrupting the communities in our lives, relationships, families, schools, sports, churches. We’re told to stay home in order to be safe. So in order to provide the greatest sense of physical safety to ourselves and others, we are disrupting the very things we need in order to have emotional safety. The connections that we all need to feel safe, to cope with stress, to manage fear and to surmount this crisis. Remember what I said, the human relationship is the most important lever that we have to manage stress and fear. So the cure, if you will, for physical safety, is exactly the opposite of what we need to be able to do to create emotional safety and manage stress.

Dr. Pamela Cantor: All of a sudden, young people are being separated from the teachers and friends they love and they no longer have the same routine or structure they become accustomed to. This is very jarring for them and for the adults. They may be very sad and upset and even angry, wanting to blame people for taking them away from where they want to be with their peers. Young people depend on each other for information and support and they depend on their schools for food, for health care and for adults they trust. Once home, students don’t have equal access to support or even technology. Or if they do, they may have to adjust to a new way of learning online from teachers who are learning to teach in a new way. Or they may have been sent home with packets full of paper assignments that are just overwhelming. And if their parents are having to work from home or having their hours cut or job or business hurt, there will be added stress at home with everyone there with new routines and responsibilities. This is a massive change in the way we live and work and learn. And it is the biggest problem today for our young people and the adults surrounding and supporting them.

Dr. Pamela Cantor: So in a way, Chris, we have an engineering problem. The engineering problem is how? How are we going to create both physical and emotional safety at the same time?

Chris Riback: So you know, the million dollar question, “How would you approach that?”

Dr. Pamela Cantor: So it’s interesting. I was speaking to somebody who lives in a very rural part of Maine and he said to me, “You know, life is not very different up here.” He said, “We’re used to living where the people we count on are mainly each other.”

Chris Riback: Yes.

Dr. Pamela Cantor: “A neighbor. It’s a very small community. We can get information from many sources because of the internet, but for support, it’s a very small community. So we have to help each other solve problems, build barns, help animals, provide for what other families need when they need something that we have that they don’t. We take care of ourselves and we take care of each other.” So it made me think about community and it made me ask the question, “How small can a community be?” Maybe as small as a relationship, a family, a neighbor, or a friend.

Dr. Pamela Cantor: Right now, the best medical advice we have is to stay away from large groups. It isn’t to stay away from everyone or to be isolated. That would create even more stress and deprive us of the one thing that we all need to manage stress, which is relationships.

Chris Riback: Yes.

Dr. Pamela Cantor: So this means that we can still build small communities, circles of trust and do it safely using the people we most trust in the world. Our ability to take care of ourselves, including using practices as simple as meditation. We can actively help each other. We can share resources and accurate information and we can use the flexibility of the internet to increase our connectivity to one another. In other words, I think we can build micro communities in which we establish who we can count on and use the bonds we form and the oxytocin that such bonds release to manage stress and fear and the uncertainty of the future.

Dr. Pamela Cantor: Restoration of routines is always good in stressful times, but there are bigger opportunities here too. Anyone can be a leader in communities born of necessity and purpose, including our kids. They can find creative solutions to problems that we might not even see, especially around the use of technology. We can use their energy, their agency, their creativity, their agility, their pragmatism, especially the teenagers among us, to do things that we can’t do. And they will respond to being needed and valued and respected as well as protected and loved.

Dr. Pamela Cantor: We are going to hear bad and troubling news every single day for some time to come. And each day our ability to cope will be tested. Every story and account of what gets people through times like this has to do with a very careful balance between facing the facts of a situation and the ability to harness our collective relational will to preserve belief that the crisis will end and that we will be okay again. This is what we most need now to do for ourselves and our children. We need to create these micro communities where relational trust is strong, in ways that make it possible to build collective strength, preserve belief, promote resilience, and we need to do it with each other every single day.

Dr. Pamela Cantor: This is a vaccine that is actually possible today. It is one which provides both physical and emotional safety to each other and all of our young people. We must follow the guidance on physical distance, but let’s combine it with the things we can do to create emotional safety and connection. Because doing both will inoculate our young people with a path toward wellness, resilience and health and the ability to recover from this life altering event.

Chris Riback: Pam, in listening to you and listening to the story of your friend or the person you know in Maine, it almost sounds like part of the vaccine, maybe what is the vaccine as you’re describing, is a return to the basics. I don’t know if that’s too simple? But maybe to the basics of humanity, which I guess is the human relationship. I mean it would seem like that is the most central component of being human is the human relationship. Am I hearing you right?

Dr. Pamela Cantor: You are, Chris. One of the things I started to think about is how over these last years there’s been such a big push around young people achieving things as individuals.

Chris Riback: Yes.

Dr. Pamela Cantor: “How I do on a test. How I do in my college acceptance. How I do in my career path.” And I thought, there’s something really interesting about a time like this that reminds us that the only way to get through this is together. That people cannot get through a time like this just by themselves. That the thing that is going to most provide an ability to surmount something like this is the collective will that we have, and the sense of responsibility that we have for one another. So this idea of how small a community can be to actually accomplish that, struck me as something that is possible. Something that we all can do, like today.

Chris Riback: Pam, that is incredibly helpful and just a really fascinating idea about the importance of building and rebuilding communities. We all could use something restorative and positive at these times and to bring us forward. As we close a very practical question, resources. Are there any places that you would recommend that parents, caregivers go to learn more about some of the ideas that you’ve been talking about?

Dr. Pamela Cantor: Thank you, Chris, for asking that question. There are many, many sources of help that are emerging and our organization Turnaround For Children is curating those. So one recommendation I’d make is the Turnaround for Children website, www.Turnaroundusa.org. Two others that I think could be really helpful, one is the Mindsight Institute, Dr. Dan Siegel and his website. And the other is the Greater Good Science Center at Berkeley. So these are three places that will have wonderful resources for teachers and for families.

Chris Riback: Really helpful, the resources of course, but really helpful on the insights and guidance and just overall tips about helping get through the times that we are in. Pam, thank you. Thank you for your time. And of course I hope that you and your family do as well as possible during these trying times.

Dr. Pamela Cantor: Thank you so much, Chris. Thank you again.