The Eight Part Covid Survival Kit

Ways to Make Your Life Predictable, Moderate, and Controllable (Covid PMC)


Part I - Structure

In an April 01 2020 edition of Psychology Today Veronika Tait PhD interviewed Bruce Perry MD and together they shared a COVID 19 Pandemic Toolkit for Parents:
Although this tool kit is designated for parents and is focused on children
we will use this Tool Kit as a guide to review over the fall and winter months to some essential tools to help us deal with stress of COVID 19 pandemic. These tools apply to those of all ages, children, adolescents, young adults, adults, and elders.
Each month we will highlight Tools to help manage this crisis and identify for you web videos, articles, discussions, and resources we have found helpful.
We value your input. Please let us know what you find helpful in this presentation. If you had an experience, questions or found something worth sharing please contact us at
This month our focus will be on the fundamentally important Tool of Structure.
In Bruce Perry‘s model, the Stress Response System evolves in complexity and flexibility over our development. The Stress response System is built from the bottom up as the child’s brain develops in his family and community and as she acquires increasingly complex tools of self-regulation through resilient experiences.
He emphasizes that the PATTERN OF STRESS is a key factor that determines the healthy development of the Stress Response System.
Stresses that are Predictable, Moderate and Controllable build Resilience.
Stresses that are Unpredictable, Severe and Uncontrollable are destructive and hinder development.
COVID-19 is a once in a lifetime event for all of us. It is not yet in our control, it has been severe in its consequences, and destructive to our social fabric.
Trying to create a safe passage through these difficult and challenging times is hard work. A primary strength in dealing with such tough times is to share the load and do it together. Bruce emphasizes the need to recognize how difficult this can be and it is essential to be kind to one another if we, our families and community are to become Resilient.
Creating Structure is Bruce’s first identified Tool. Creating Structure is a work in progress not a fixed Destination. Developmentally tuned Structure provides safety, predictability, and trust for us to explore, experiment, adapt and create.
We thrive, particularly in adverse times, with structure and routine; these are comforting, and they give us a sense of control and predictability. This is particularly important when the COVID-19 crisis has led to such significant disruption and uncertainty in our lives. We cannot predict the many turns this virus will take, nor understand precisely the challenges to our own well-being, we can incorporate a level of fidelity to our routines. Rituals, like mealtimes, exercise, planned breaks, regular meetings, etc. are grounding and comforting. 
So, what are structures and routines? Simply put, a structured environment is one that is organized and predictable. When we have day-to-day routines and a schedule to follow, this creates structure in our lives.
How to Create Structure for Children
  • Identify important daily activities and decide the order they should happen.
  • Identify key times of the day when the activities should occur and make a routine.
  • Example: Bedtime Routine
  • 7:15 begin with washing face and hands, next, brush teeth, after that, put on pajamas
  • Read Aloud from a book of the child’s choice
  •  Last, tuck-in and kiss good night
  •  Lights out
How to Create Structure for Pre-Teens and Teens
  • Identify important daily activities and structures. Decide which ones are not optional and therefore, predictable.
  • Example:
o  Attend school regularly
o  Attend family meals at least 3 times a week
o  Do schoolwork nightly
o  No screens 30 minutes before bedtime
o  Set a sleep routine to get 8 to 10 hours each night
o  Be in bed/home by ____________
o  Let them know you will always be there for them no matter what
How Young Adults Can Create Structure
·    Add structure to your life to focus on what is most important to you.
o  Wake up and go to bed at the same time as often as possible
o  Set a strict sleep schedule to get 7 to 9 hours sleep each night
o  Build in reminders so you don’t forget or get sidetracked.
o  Learn to budget your time:
·    Time for studying, for working on assignments,
·    to keep in contact with friends and family
·    to clean your room/apartment, do laundry
o  Take 10-minute breaks (step away) from a task, 2 to 3 times a day
o  Schedule in mealtime; for at least one full meal a day
Creating Structure and Routines for Adults: Example Morning Routines
Planning routines help you know what to do next, even if things go wrong. When routines break down, things go awry. Focus on the here and now not the hypothetical and you will decrease stress and anxiety.
o  Plan your morning at night. Set your goals. What do you wish to accomplish? Create a block for important tasks.
o  Put your clothes out for work. Make your lunch.
o  Wake up at the same time. Set an alarm you can live with.
o  Eat a healthy breakfast
o  Exercise for at least 15 minutes
o  Meditate, take some time for yourself
o  Try not to anticipate problems, address only the ones you have control over
o  Get dressed, play music to help you get your day started
o  Gather up your things, keys, wallet/purse, lunch, etc.
o  Get out the door!
Senior Citizens Need Social Routines/Structures to Stay Connected
o  Daily exercise in any form is beneficial, especially with a companion
o  Each day connect with a family member, friends or someone in your
o  Take time to stay emotionally connected whether it be a person, pet or spiritual being
o  On a weekly basis reach out to others, participate in church activities, volunteer for Hospice, or for other community services
o  On a weekly basis participate in Senior Center or community activities
Not all of us have the same starting point or resources to deal with stressors. For those with limited resources and unpredictable futures these are very difficult times.
Bruce Perry’s YOU TUBE COVID 19 talk about Stress may be a good place to begin.
Some find the presentation a bit philosophical others terrific.
Babette Rothschild, a clinician I admire, has a Scandinavian quote “at tigge pa“. It means “chew on it “. If it does not taste good, you should spit it out immediately.
However, if it tastes OK then just swallow a little and see how it goes just before swallowing the whole thing.
Bruce Perry’s YOU TUBE COVID 19 talk as a background FOR dealing with Stressors approx.16 minutes
Links to other resources you may find helpful
The COVID 19 Workbook Practical tips for your family during this time of quarantine.
Laura Domer-Shank, ED.D approx. 27 minutes
How To: Dealing with Changes (COVID 19) contains Comic Strip Conversations
Approx.15 minutes
Helping Seniors Manage Loneliness and Anxiety During COVID 19
On Our Sleeves The Movement to Transform Children’s Mental Health
NFI VT COVIS-19 Wellbeing Ideas, Melnick
Creating Impeccable Structure for Your Life: Leo Babauta
Dr. Bruce Perry’s COVID19 Series;
The You tube about Stress and Resilience https:/
The Eight Part COVID-19 Survival Kit
Ways to Make Your Life Predictable, Moderate, and Controllable (COVID-19 PMC)
Part II – Kinship (Core Group)
IPart I of our COVID-19 Survival Kit, we highlighted the human need for Structure in creating PredictableModerate, and Controllable environments within our lives to help us mitigate the stresses of this time of a world- wide pandemic. This need for structure is not chosen but is wired into our brains. When our physical and social expectations are not met, we become stressed, setting off our Stress Response System (SRS). Depending upon the degree of the stress, our brains alter our responses to the world and how we perceive it with either positive or negative results.
The second tool in Dr. Perry’s COVID-19 Survival Kit that is essential in helping us navigate our lives in these difficult times is maintaining Kinship with our Core Group, a basic need for us as a social species to connect with and to belong to which, is wired into our DNA. Perry states, “We are dependent creatures-unavoidably interdependent of one another.” In his work, Perry, addresses the importance of human connections in the management of stress. Not having predictable and safe social connections with one’s core group whether it be family or very close friends, can make our Stress Response System (SRS) respond as if we were under a mortal threat. However, recognizing the cause of this stressed state and our response are under our control. Just like other parts of our brain set off an alarm when we are hungry and need food, our Stress Response System (SRS) lets us know we need social connection when we are lonely. Loneliness calls out for the safety of connection. What sooths and lessens social pain and deactivates the Stress Response System (SRS) is the warmth of the human touch and connection. Belonging is essential to our survival.
However, it is important to make clear that the feeling the “loneliness alarm” sets off is different from just being alone. The ability to enjoy being alone and comfortable with one’s self in SOLITUDE, is a resilient strength based on the experience of a felt sense of safety and the ability to explore and reflect on our own. Developing resiliency when facing stressful situations like those brought about by life in the COVID-19 era is a positive outcome. But failure to respond to the stress of loneliness in a positive and realistic way can lead to increased anxiety and depression.
Loneliness is a social pain as real as physical pain and can affect one’s physical health.
When you perceive your social world to be unpredictable and socially unsafe, it wears you out and makes you more susceptible to illness. During a pandemic when we are being asked to isolate, socially distant, and quarantine, we need to be thoughtful and creative in order to alleviate the stress caused by loneliness.
We hope that you might respond to this series by email to or call us at 508-778-4277 if you have questions or comments or have personal experiences to share. We would welcome hosting a Zoom discussion group on any one of the eight topics. Below are interesting and informative links and as well as ideas and activity suggestions for people of all ages as we go through these socially distancing times and the 2020 holidays.
 The Counseling Teacher: 6 Engaging Anxiety Management Activities for Kids
Children worry about how the coronavirus has changed their lives and what is next. The activities in this website also apply to children at home during the pandemic.
·      Belly Breath
·      Worry Box
·      Draw/Write Away Worries
·      Tear It Up Today
·      Worry Escape Room Activities
·      Marathon Kids
Helping Kids Cope with Loneliness During COVID-19
Loneliness due to the pandemic is particularly tough on children. Compared with adults, kids tend to have a harder time communicating their feelings.
Indoor activities for the whole family that maintain a sense of connectedness.
Fun easy games using household items are explained. For example: Hide and Seek with Objects, Q-Tip Blow Dart game, Cereal Puzzles, Milk Jug Catch and Cotton Ball Races.
·      Play games indoors! Games for younger children include Simon Says, Duck, Duck Goose, or Follow the Leader.
·      Older children can play “I Spy,” Charades, indoor bowling, or make up new games.
·      Try a new recipe or make dinner as a family; find recipes and tips for cooking with children safely on the Cooking with Kids webpage.
·      Read a chapter book together and discuss the characters and plot and ask questions to encourage critical thinking.
What to Do at Home with Your Kids During COVID-19
Tips for Families: Coronavirus
Young children are highly affected by the quarantine and the anxiety of their parents and other adults. This article discusses five things parents can do to help their child.
Helping Your Child or Teen Stay Socially Connective and Safe During COVID-19
·      Don’t take away your teen’s phone, rather schedule times to put it away like mealtime and bedtime
·      Communicate – teach them advocacy
·      You may need to designate certain times when they can be alone and others when they are expected to interact with family.
·      Allow limited computer or video game time. Coordinating time with a friend so they can skype and compete will help keep your teen connected to their peers.
·      Remind your teen you or another family member they are close to are available to support them during this difficult time.
Supporting Teens during COVID
65 minutes long
Panel discussion with 6 professionals.
Staying Home During Covid-19: Help Teens Cope, Nilu Rahman, M.S., C.C.L.S.
“Teens cut off from their normal activities and stuck at home want to feel like they have purpose and meaning,” Rahman. The article discusses ways to help teens respond to loneliness and decrease anxiety and depression.
Young Adults:
Toolkit for People 18-24
This website offers a wealth of information for several topics including Structure and Isolation such as...
  • Web Resources
  • FAQs
  • Posters
  • Fact Sheets
  • Social Media
  • Videos
The lethality of loneliness: John Cacioppo
Loneliness is a stigmatized. It is the psychological equivalent to being a loser in life or a weak person. Stigmatisms lead to denial. Loneliness can be dangerous. When something happens negative in the social environment, that brain is focused on self-preservation, not a concern of the other person.
What to do about the dangers of loneliness.
1.    Recognize what the signal is and don’t deny it.
2.    Understand what it does to your brain and to your behavior.
3.    Respond: the quality of a few relationships is better than quantity, share good times
Your Brain on Social Distancing: Loneliness & Isolation During COVID-19 Coronavirus
(about4 minutes)
Animated characters give 7 tips to manage isolation and loneliness.
For the elderly population socialization is essential. Research supports that socialization plays a significant role in their overall health. Also, planned activities can provide structure and purpose that helps to keep the elderly rooted to their community and makes them feel more connected to themselves. The following excerpt is a true story of how an 82-year-old woman found the right place to restore her connectedness and purpose.
When it became obvious my mom was likely presenting behaviors indicative of dementia - paranoia, fear, and expressions of loneliness, her actions became most worrisome for me as her daughter. She had always been very active and social. Slowly her activity and social interactions began to wane. When it became clear it was no longer safe for her to live alone, we found a Senior Living Community she liked. She moved into the Assisted Living section. This allowed her to come and go from the building at will. Although this new lifestyle provided for plenty of socialization, she continued to tell me she was lonely. Nine months after moving into Assisted Living, it became obvious to my family and the staff that it was time for her to move into the Memory Care section of the building.
I was bracing myself for her to become angry and resentful of this new living situation that would "take away her freedom” and make her a "prisoner". To my amazement the opposite has happened. She tells me she doesn't feel lonely. She seems to have fallen back on her nurturing qualities and the skills she developed while volunteering for the Council On Aging in the past. I am told she will walk into a staff meeting and participate with very good ideas, she supports others who live there when they are feeling sad, and she helps staff with setting up activities. She has found purpose, satisfaction in helping others, and seems to be thriving in ways I never would have thought possible!
Activities for the elderly in lockdown and isolation that help build a sense of safety and strengthen resiliency.
·      Coloring
·      Drawing
·      Sorting objects
·      Crosswords, word searches, hidden words
·      Sensory boxes
·      Grow indoor plants
·      Learn to Skype someone
·      Play digital games like Sudoku, Solitaire and Scrabble
Establish a routine for exercise indoors
·       Walk, march or jump in place
·       Lift 2-3 lb. object while exercising muscles and body parts
·       Dance
·       Yoga: stretch and extend muscles
Additional Links
Ideas for Activities at Home During COVID-19 Pandemic
Activities for deaf-blind children as well as visionally impaired
Tag #M25challenge!
Excellent learning activity for days-of-the-week, each with a task to performed, followed by a challenge and a new word definition and ways to pray. Really pulls a family together.
Making 'Social' a Superpower in the Classroom - Matthew Lieberman
“Social Pain” is more than a metaphor. A broken heart is real.
John Cacioppo on How to Cope with Loneliness | Big Think
Cacioppo tells us to concentrate on 1 or 2 meaningful relationships. Expect the best but don’t expect it to be perfect.
Tool Kit for People 15 – 21
How Seniors Can Cope During COVID-19
The Eight Part COVID -19 Survival Kit
Ways to Make Your Life Predictable, Moderate, and Controllable (COVID-19 PMC)
Part III – Socialization
In Part I and Part II of the COVID-19 Survival Series, we have discussed the importance of Structure and Kinship (Core Group) as outlined by Dr. Bruce Perry and their relevance in establishing PredictableModerate, and Controllable environments for learning and developing resilience. We have also recognized the core concept that we are social in our nature. In Part III of our series, we are addressing Socialization, a challenge in our present world where self-isolating is the suggested norm, and its effects on the individual and on the community as a whole.
Babette Rothschild, a clinician who works with people and communities who have undergone trauma, describes this social nature as “our relations are woven in, around, and through the fabric of our beings and entwined in everything that we do.”
Hopefully the discussion of the first two tools in our tool kit have taught the following about relationships:
1.    Learning happens in the context of relationships and that within the context of social bonds, we develop the motives and the values that guide our lives.
2.    What we learn in the context of those relationships impacts outcomes. Our individual community and national responses to the COVID-19 crisis has made this very clear.
3.    Building positive, trustworthy, and safe relationships in our family, our clan, and our community is essential for the growth, creativity, and resilience of each of these domains.
4.    When you are connected, you feel protected and capable of new learning, discovery, and exploration. When you experience physical or social threats, new learning is not possible.
The sense of care and connection figures predominately in our well-being. Positive social relationships are better predictors of well- being than economical or biological factors and serve as buffers to life’s trials. Perceiving others as social threats undermines feelings of social connection, activates our Stress Response System, impairs our ability to learn, cooperate, face, and adapt together to stresses and can create a negative bias looking out into the world.
When under stressors that are UNPREDICTABLE, EXTREME, and UNCONTROLABLE, it is easy for the road to hell to be paved with good intentions. Many of the neural networks involved in experiences of physical threat and safety are also attuned to social threat. Social support reduces both physical and social pain. Rejection, exclusion, and dismissal in our social networks over time are painful and limiting to the individual and to the community.
The ability to learn and develop social and cognitive skills requires practice, hard but rewarding work and pro social attitudes. Wellbeing for ourselves and our community is hard and meaningful work and requires team work.
We, at NAMI CC&I, are very fortunate to have so many individual and community connections and alliances with whom to work in our efforts to foster well-being in the Cape and island communities.
Reaching out and socially connecting for individual benefit or for the benefit of the community is a challenge during this period of pandemic. The following resources offer ways for people of all ages to continue to socialize during COVID-19 restrictions, both for the good of their own mental wellness and for the health of the community as a whole.
Dr. James McGuire, NAMI CC&I Board of Directors
( Parts I and II of the COVID-19 Survival Kit can be found on our web 
PART III Helpful Links
Generosity and kindness can be taught
Respect -- and nurture -- your child's natural inclinations to do good
Children help because it feels good
Giving kids prizes and toys for helping isn't such a good idea.
Kid’s President 25 Reasons to Be Thankful
Life is tough. It’s important to remember the things that are awesome.
Activities to Help Your Autistic Child (or any child) with Social Skills
Eye contact
Help with idioms
Interpreting emotions
Stay on topic
Children: Giving Back
  • Promotes positive self-esteem and a sense of purpose
  • Improves a person’s ability to manage stress
  • Increases self-confidence and promotes positive behaviors
  • Helps introduce children to positive role models who may provide positive encouragement and support
Ways to Give Back
donate toys, send a kindness card to healthcare workers or community services people, etc.
perform a service: yard work or dispose trash for an elderly neighbor, offer to babysit or do childcare
Family Connect-Being Thoughtful in COVID (spiritual message)
Provides thought provoking questions that help you look for the joyful even when things are hard.
Families are encouraged to try activities they have not done together before COVID e.g. keep a COVID journal, write something you did as a family everyday and take a picture. Keep it as a record for your children.
Keep Connected with Your Neighborhood from Your Sidewalk, Front Door or Driveway
Play bingo using a megaphone
Say hello at night by switching your lights on and off
Lead each other into singing familiar songs
Turn up some music, dance like no one is watching
Exchange jokes with each other
Donate your time outside the home:
Blood Bank Centers, Food Banks, Homeless Shelters and Meals on Wheel
Run errands for elderly
When out and about, smile at people
Donate Your Time From Home
Virtual babysit depending on child’s age, offer divergent activities so parents can get work done
Go to Points of Light Volunteers to find out what you can do
Use Facebook/social media to create a help line
10 Proven Ways to Stay Connected During the Pandemic
Humorous approach to not feeling isolated
1.    Don’t panic
2.    Take pleasure in your own hands
3.    Say hello—don’t ignore each other
4.    Make a list—who are you connected with? Start with who you are most connected with and end with who you are connected with the least, then contact that person
5.    Dance like nobody’s watching
6.    Break bread together—cook with someone in your house
7.    Connect with nature—go outside, notice what’s near you
8.    Feel it with music
9.    Always play everywhere—do something silly in a place you normally would not
10. Reach out to your tribe/community—we are all social creatures, it’s natural
COVID-19 Wellbeing Tips for Teens with Dr. Watson Clinical Psychologist
This video provides teens with strategies they can use to stay calm, focused, and motivated while everything around them is changing and uncertain. You will learn tools for soothing feelings like fear, confusion, and boredom; staying focused and hopeful; and choosing actions that support wellbeing in both the short and long term.
Young Adults
How Young People Can Cope
Researchers argue that one-way young people can combat mental health struggles is to try to deliberately savor ordinary, everyday experiences by using the five senses to amplify positive emotions and promote a sense of calm. This is pretty much the opposite of what some of us are doing when we spend hours a day consuming COVID-19 news, which can hurt our mental health. Researchers also highlight the crucial role of human connection and social support. Finding ways to stay connected and give and receive support can help combat the traumatic experiences many are facing due to this global pandemic.
5 Things You Can Do to Help Young Adults Cope with Social Distancing
·       give emotional space
·       have grateful moments
·       encourage a schedule
·       make regular connections
·       promote sleep & physical activity
10 Ways Young People are Leading the Way Against COVID-19
Women Deliver Young Leaders perform vital work on the frontlines of the pandemic response
Staying Connected
Does your neighborhood have a Face Book Group or a group email? Ask to join and see what fun activities you can share. 
One neighborhood put shamrocks in their windows for kids to find while walking.
Another neighborhood promoted themed sidewalk drawing competitions for different age groups or families.
Use a video chat app to make a game night, dinner party or coffee date
Make a good old fashion phone call
Snail mail, write a note or send a card
Create and follow a daily routine, try to include regular daily activities such as walk the dog or pick-up the kids
Check in on your loved ones often
8 Ways You Can Help Your Community Amid the COVID-19 Crisis
Give Five Wave Five
Give $5.00 to a local food bank when food shopping
Transition to Donati(on)
Use the money you’re saving on gas to buy gift certificates for local restaurants
Conversations With Dogs
Nod your head, say hello when you walk by people.
Wholesale Order Up!
Order from local wholefood sellers who are losing some or all of their business
Masks for All
Collect and donate unused N95 masks
Dine inside
Making sure we can do either curbside pickup or contactless delivery
The start of something new
Staying Connected/Giving Back
·      Call 10 people a week you know are alone (get a list from your church or senior center if necessary)
·      Stick to a routine: exercise, reach out, read, mediate, do a word search or puzzle, eat a regular meal
·      Get a new hobby: buy a bird feeder and book about birds, genealogy, photography or another new hobby.
·      Sit at your front door or window and wave hi to your neighbors
·      Call your grandchild or neighbor’s child and read a story over the phone
·      Call a friend and watch a movie together or have a cup of tea
·      Have a curbside social hour bring your chair to the driveway and have a fun visit
·      Buy and/or deliver groceries to other seniors that are homebound
·      Volunteer opportunities, the Smithsonian Institute, help transcribe important documents, and StoriiTime connects senior readers with children via video call in the US, Canada & UK. (
Pen Pal or Phone Friend
Connect to patients in assistant living centers who have been in lock downs to stop the spread of COVID.
RESILIENCY AND THE COVID-19 PANDEMIC: The Hidden Strengths of Those with Lived Tip Sheet Experience of Mental Health Conditions
6 Ways to Improve Your Child’s Social Skills
Steps parents can take:
·       Follow their interest
·       Learn to ask questions
·       Practice role-playing
·       Teach empathy
·       Know your child’s limits
·       Be a good role model
Here are 17 research-inspired social skills activities for kids, organized loosely according to age-group. It begins with games suitable for the youngest children, and ends with social skills activities appropriate for older kids and teens.
How Can I Stay Connected with Others During COVID-19 While Distancing Myself Physically?
Validate it’s a challenge to stay connected. Try to talk to someone outside your home every day.
It’s a sign of stress, if you’re finding you do not have energy to respond to people that are checking on you each day. That may be the time to reach out to a friend or therapist.
The Eight Part COVID-19 Survival Kit
 Ways to Make Your Life Predictable, Moderate, and Controllable (COVID-19 PMC)
Part IV – Screen Time
In this day and age, screen time is a blessing and a curse. The past year, as we have struggled with adjusting our lives to living during a pandemic and we have come to rely on our screens as lifesavers as we communicate on-line instead of in person. We have Zoom meetings, we work from home, our children Zoom into their classes. Zoom cocktail hours, Zoom fundraisers, and facetime with children and grandchildren have become the norm. We have seen screens become our way of life. We can be thankful for this technology that has kept things happening during this crisis.
On the other hand, screens can be our enemy when they are allowed to dominate our physical and emotional lives. Sitting in front of a screen all day and into the evening is not healthy when we are not exercising, not eating healthy meals, and overdosing on sensation, often frightening news stories. We need to moderate and control our screen time. We need to be mindful of who is in charge – the screen or us!
Jackie Lane, ED
 We are fortunate to have Dr. James McGuire, a practicing Cape Cod psychiatrist, as a valued partner in producing this series. Here are his thoughts on screen time during the pandemic, followed by resources and actionable steps for people of all ages when dealing with screen time:
Happy New Year now seems like an incongruous greeting! This month, January, has been an exhausting, uncertain, and dangerous time to experience.
The videos and descriptions of the insurrection in our nation’s capital, the death toll of the coronavirus climbing to over 400,000, the uncertainty of the distribution of the vaccines and to whom they will be administered, the presence of new and more contagious strains of the coronavirus, and the secular/ religious wars in politics have been discombobulating and overwhelming for me.
In the last three NAMI newsletters, we have been sharing items in our COVID-19 tool kit patterned after the recommendations advised by Bruce Perry, MD, PhD of the Child Trauma Academy.
We have shared information about our brain’s development that occurs in a social context and the importance of providing a shared safely structured, Predictable, Moderate, and Controllable environment within our family, kinship, and community.
Dr. Perry warns us that as we navigate our way through the pandemic, our Stress Response System (SRS), will be chronically activated and we will become physically and emotionally exhausted by the felt sense of threat to ourselves and our community. He reminds us that dysregulated defensive negative emotions that emerge are contagious like the virus, and can quickly spread within the community with disastrous consequences, which we have all just witnessed. The importance of Predictable, Moderate, and Controllable social contexts that allow us to self-regulate and operate in a more reasonable and constructive manner becomes obvious.
Over the past month I have been re-watching several of Dr. Perry’s webinars. They have been helpful to me, so I am again recommending a review of some of them.
(I am also aware of the president’s recent advice to his aides whose advice was too academic. He suggested that the aides might call their mothers, share their ideas with them and if they understand, proceed!)
So, with caution, I recommend the following Bruce Perry’s presentations:
State-dependent Brain Functioning: “Neurosequential Network Stress & Trauma Series” time: 21:57
Emotional Contagion: “Neurosequential Network Stress & Trauma Series” time: 17:53
Regulate, Relate, Reason (Sequence of Engagement): “Neurosequential Network Stress & Trauma Series”
 Our topic for this month’s Nami newsletter is Screen Time. I am broadening this umbrella and including social and digital media.
For me, my use of digital media comprises of using it as a tool to research topics of interest on Google Scholar and YouTube, watching movies, checking out the news in the evening and during the day on my phone, and playing dominoes.
We at NAMI have collated articles, YouTube, Vimeo presentations and webinars, about navigating the Default Digital Age we are living in and have highlighted those we have seen as most helpful to us.
  1. The Family Digital Wellness Guide which is downloadable. Here you will find the science-based guidance for raising happy healthy children from toddlers to teenagers in today’s digital environment. Built on a bedrock of research the Family Digital Wellness Guide will give you a quick overview of your child stage of development and how it relates to the media they use. You can explore the guide through its interactive webpages. The guide addresses the effects of screen time on the developing brain in childhood and adolescence with practical suggestions for entering a discussion. **
  2. “The Effects of Screen Time On The Developing Brain,” a Vimeo webinar of the New York Academy of Sciences. This is a roundtable discussion of digital media that is a thoughtful and informative discussion of the realities, risks, and benefits of screen time.
  3. “Education Now: Screen Time Sanity,” 38:56 minutes)
  4. Parenting for a Digital Future. This is a book by Sonia Livingstone and Alicia Blum–Ross that broadly reviews Digital Media and its impact both positive and negative in our lives. ***
My sense after reading and viewing the information is to:
·      Make screen time a developmentally appropriate activity used in moderation and a part of a healthy balanced lifestyle.
·      Discuss Screen Time with children and teens and in-betweens as a part of a forum for sharing and collaborative problem solving between parents and children.
·      Use digital media to foster cohesion in the family and include Important discussions about living through COVID-19 and digital health.
·      Model the behaviors you would like others to follow.
·      Understand a new world with COVID-19 with thoughtfulness and patience.
·      Make an effort to let your children and teenagers help you learn digital media.
·      Accept that screen time for teenagers is the critical social environment for them with all its pluses and inherent problems.
·      Stick to the general rules of making the digital world as Predictable, Moderate, and Controllable as possible, understanding the critical importance of different social contexts require different solutions.
·      Make screen time value laden with your values and an active collaborative decision-making process within your family or community when possible.
·      Spend time together using screen time as an opportunity to discuss how the world we share can be experienced differently.
Part IV - Resources 
Both adults and children are experiencing an increase in screen time, but experts are saying it’s going to be OK. In fact, there’s actually very little evidence directly connecting screen time to harm in kids. The bigger problem lies in screens replacing positive activities like exercise, socializing, and sleep. Here are three simple things to keep in mind.
One media-free meal per day.
·      Don’t even have the TV on in the background
Two screen-free hours before bed. 
·      “Blue lights” can disrupt natural sleep patterns and wake-up time
·      Keep phones out of preteens and teens bedrooms at night
Three ways to measure screen use:
1.    The amount of time spent using a screen 
2.    The quality of the content
3.    Being there to help your child process what’s on the screen
Other suggestions from Canada’s Healthy Relationships Hub:
·      Set time limits but be flexible and gentle with yourself: it’s fine to allow more screen time than usual, as long as it’s age appropriate.
·      Allow children to play and interact with friends: it is important for children to maintain relationships with peers. Under appropriate supervision, kids
FaceTime their friends, play online games, or send silly videos.
·      Watch TV and movies together with children: Experts suggests that parents and caregivers watch media with children when possible and talk through it. Co-viewing can support early comprehension and literacy skills and boost empathy.
“Is All Screen Time Harmful to Teen Mental Health?”
Teens speak openly and frankly about internet use, content and language may not be suitable for children
Young Adults
Author Jennifer Nelson (2021) advises:
§ viewers that blue light from devices signal our brain to wake-up.
§ Setting night filters on your devices to reduce blue light will help with sleeplessness.
§ Turning off screens an hour before bedtime is a must for a good night’s sleep.
§ Be aware of the emotional cost of staying informed and connected. Give yourself a break. Set limits on time spent scrolling negative content and set an alarm to enforce them.
§ Practice being “unavailable” sometimes. Try leaving your phone behind for short periods of time. Limit or delete any endless scrolling through content on Netflix, Instagram or elsewhere.
§ Connect with people on social media that share your values, interests, and pursuits. Find ways to use your screen time to contribute, create or pursue goals.
§ Mute notifications that constantly alert. Limit screen time while participating in other activities so you won’t miss moments that create contentment and happiness.
*Put your alerts on hold.
*Limit your screen time after sunset.
*Daily email detox.
*Get your work done without distractions!
*Intermittent social fasting.
*Avoid social media during working hours. With increased focus, you’ll lower your chances of having to work late.
Dr. Vivek H. Murthy, author, Togetherness, suggests four recommendations addressing the social strains we’re experiencing:
1.    Spend more time with those you love—at least 15 minutes.
2.    Focus on each other and give one another your undivided attention.
3.    Embrace solitude. Connecting with yourself is a prerequisite for connecting with others.
4.    Help and be helped.
Screen time is higher for the elderly than younger people, new data reports.
Five best uses of screen time for older adults
1.    Talk live to the people you care most about on FaceTime, Skype, Zoom or other video conferencing platforms. Or text them to share your appreciation and gratitude.
2.    Watch a TED Talk every day. The nonprofit organization claims more than 3,300 talks to “stir your curiosity."
3.    Watch a nature video. You may not be able to escape to the great outdoors, but you might meditate to that video of a babbling brook.
4.    Record a video of stories from your life to share with your kids and grandkids.
5.    Visit the places online that help you nurture your most passionate creative pastimes.
Other Resources
Family Digital Wellness Guide: “What Parents Need to Know About Media and Their Children,”
Boston Children’s Hospital 2020 Version download at
This guide provides a wealth of information for parents of children ages infants to teens in an easy to read and comprehend format.
“COVID-19: Screen Time and the Developing Brain,” presented by; The New York Academy of Sciences Reported by Barbara Knappmeyer Posted July 30, 2020
“Staying Emotionally Close In The Time of COVID-19,” Bruce Perry, MD, PhD
New report on teens and mental health: How screen time impacts kids
“Digital by Default: The New Normal of Family Lives Under COVID-19.” This is a blog by Sonja Livingstone Dr Phil. It takes 5 minutes to read and a week to digest and is child and family centered. **
“Digital Advertising To Children.” An article in the July 2020 journal Pediatrics by Judy Radesky, MD that gives an overview of the use, methods, and intent of advertising in gaming and social media.
Garfin, D. R., Silver, R. C., & Holman, E. A. (2020). “The Novel Coronavirus (COVID-2019) Outbreak: Amplification of Public Health Consequences by Media Exposure.” Health Psychology.
Nelson, Jennifer Digital Detox, “Are We Too Attached to Our Digital Devices?”
bp magazine Winter 2021
“How to Handle Screen Time During the COVID-19 Pandemic,” Dr. Michael Rich, Director, Center on Media and Child Health, Boston Children’s Hospital
“How to Manage Your Screen Time While Staying Home,” March 25, 2020/General
Dastagir Alla E., January 7, 2021 “What To Do About That Pit In Your Stomach In This Terrifying American Moment” USA Today
The Eight Part COVID-19 Survival Kit
Part V
Ways to Make Your Life Predictable, Moderate, and Controllable (COVID-19 PMC)
From Dr. James McGuire:
We are now going to learn about the 5th tool in our COVID-19 toolbox.
First an informercial!
If I were to ask you whether you would consider this tool, you would likely want to know more about it, its uses, its benefits, and its costs. If I told you that his tool is free and has been used by humanity for millennia in a variety of ways and that using this tool could add years to your life, but even more important improve the quality of your life and your sense of wellbeing, would you be interested in learning more about this tool?
If, in addition, I told you that using this tool will improve your immune system, protect you from stress, relieve anxiety and depression, improve your moods in general, allow you to be more successful and productive at work, play, and life and also decrease your chances for developing chronic illnesses such as cancer, heart disease, diabetes, and dementia, would you be interested in learning more?
And finally, would you consider adding this cost free tool, which can be added at any time in your life with the benefits noted above, and can be used in conjunction with all the other tools we have previously discussed, if the only requirement is creating the time and commitment to allow it to happen?
If so, read on!
I will be 80 at the end of this year and importance of making exercise an essential part of my physical and mental wellbeing has never been clearer. One of the reasons that I am so interested in exercise is because I know it has been a good companion in my life’s journey. Exercise is important in any age group, and certainly in the over 65 group whose numbers have tripled in the past hundred years, becoming 13% of the population. Cognitive decline is part of aging and we are a nation that is getting older. It is projected that by the year 2050, there will be 14,000,000 people suffering from Alzheimer’s in this country. Protecting ourselves from this uncurable disease includes physical exercise. In fact, exercise is an essential ingredient to quality of life and wellbeing form birth to senescence.
When we talk about adding exercise to your life, we are not talking about becoming Olympic athletes. We are talking about engaging in physical activity in a myriad of forms available to all. When we talk about exercise at a baseline, we are talking about engaging in a physical exercise that increases your heart rate and may leave you a little out of breath. It creates the brain fertilizer that maintains your brain, your physical health, and your well- being.
In our discussion of tools with which to cope with COVID-19, we have paid attention to the importance of STRUCTURE, SOCIAL CONNECTIONS, and PREDICTABLE, MODERATE, CONTROLLABLE LEARNING environments.
John Ratey MD, is a psychiatrist who over the past decade has highlighted the importance of EXERCISE for our brain’s development, our health, and our well-being. He reminds us that 10,000 years ago, humans were hunters and gatherers emerging out of Africa following the last Ice Age whose survival depended upon working together using predictable, coordinated, rhythmic, shared physical and social skills independently and as a group. He reminds us that human beings have always been on the move, moving separately or as a member of a clan. Moving is a part of our essential nature, part of the rhythm of our lives. All our talents and intelligences are grounded in experience that is complex, patterned, rhythmic, physical, and social. Our physically embodied exploration of the world is grounded in EXERCISE.

Below we have again collated annotated articles, You Tube, and Web presentations about exercise and its wellbeing across the life cycle.
The following research and information is submitted by Debbie Bratcher, staff member at NAMI Cape Cod. It is meant to compliment Dr. McGuire’s presentation.
In our previous Tool Kits, we have discussed that Predictable, Moderate and Controlled environments can help us self-regulate and develop resilience. Exercise: when scheduled regularly, is mindful, creative and works for our body allows us to operate in a more sensible and positive manner.
Bruce Perry, MD, Ph.D. states: The only way to move these super-high anxiety states, to calmer more cognitive states is rhythm. Patterned, repetitively rhythmic activity: walking, dancing, singing, repetitive meditative breathing--you use brain stem-related somatosensory networks which make your brain accessible to relational reward and cortical thinking. 
The list of repetitive, rhythmic regulations used for trauma by Dr. Perry, Dr. Bessel van der Kolk, Dr. Pat Ogden and others is remarkable. It includes singing, dancing, drumming, and most musical activities. It also relies on mediation, yoga, Tia Chi, and Qi Gong, along with theater groups, walking, running, swinging, trampoline work, massage, equine grooming and other animal-assisted therapy…even skateboarding.
The following links are meant for your viewing pleasure. They are examples of people enjoying music and or rhythm and exercise.
Twin Toddlers Escape From Their Cribs To Have Overnight Party
Rhythm is fun. However, this concept has a much deeper meaning in the role of childhood regulation and the development of resilience. Rhythm is really about predictability. What is it about predictability that is so good for children? American psychiatrist and author Bruce Perry, MD, PhD, suggests that the only way children can move from a state of high anxiety and activation to a calmer state is through rhythm. 

1.Self-Regulation as Rhythm
As caregivers, we have a role in helping children organize their feelings and understand their own particular rhythms regarding sleep, hunger, moods, and energy levels. When children listen to their body rhythms they learn that they can trust their bodies to let them know what they need and that they can trust themselves to get their needs met. Through listening to their body, they will develop a sense of personal responsibility and agency.
2. Rhythm Through Structure
When we provide routine and predictable structure in the home and in children’s other environments, children benefit in a lot of ways. Predictability fosters trust (“But mom, you always scratch my back before bed!”) and allows children to anticipate their day and their expectations. The key, however, is to find a balance between predictability and rigidity.
3. Rhythm Through Activity
There are countless benefits to children engaging in movement, arts, music, and reading. Why is it that children love rhyming stories, dance, swimming, play, drama, and games? One of the reasons is that these activities facilitate regulated nervous systems. One of the best ways we can help children develop calm and regulated nervous systems is through activities that expose them to an alternation between settled and aroused states. 
There are numerous ways that we, as caregivers and helpers, can create predictable rhythm in children’s lives. As children are naturally drawn to rhythm, we can effectively cultivate relationships, environments, and activities that will facilitate regulated brains and promote resilience.
Teen Loses 60 lbs. Jumping Rope
This is a story about a teen who improves his health and self-esteem.
Rhythmic movements are important to teens. These kinds of movements such as walking, running, swinging, swimming, swaying help develop the process sensory information and access the cortex. Access to the cortex is the basis for many skills such as focusing, control of impulses, managing the emotions, abstract thinking, learning, planning, making decisions and using foresight. According to the U.S. Department of Health and Human Services, teenagers should get at least 60 minutes of exercise per day. They should focus the majority of this time on moderate or vigorous exercise and include some strength training three times per week.
Young Adults
Dancing Bhangra for Joy, Exercise and Positivity | Yukon, Canada
The benefits of exercise as a young adult are life lasting. According to a recent study, presented by the Association of Academic Physiatrists, data collected from the exercise habits of 413 people aged 25 to 65 in Taiwan found that if you were active as a teenager, you are more likely to have those habits stick with you for life. The result was that those who had consistent exercise habits as teens performed much better on the strength, endurance, and function tests compared to those who didn’t exercise much in adolescence. They also, found that those who had consistent exercise habits as teens performed much better on the strength, endurance, and function tests compared to those who didn’t exercise much in adolescence.
An 11-Minute Body-Weight Workout with Proven Fitness
One of the hallmarks of these programs is that you perform the exercises consecutively but not continuously; that is, you complete multiple repetitions of one exercise, pause and recover, then move on to the next.
Lively 30 Minute Senior Zumba
The immobility of the seniors increases their vulnerability making them suffer from stiffness, aches, and pains like the tinman with no oil. Health experts believe that physical health decline occurs if the person doesn’t have enough physical activity. Therefore, one should not forget about the benefits of sport and fitness activities for the elderly.
1.     5 Best Exercises for Seniors
Simple armchair exercises, directions are easy to follow
2.     10 Minute indoor Walking Workout for Seniors
3.     Silver Sneakers At Home Workout (free)
Any Age
Tai Chi 5 Minutes a Day Module 01 - easy for beginners
In a 2018 study from Trinity College Institute of Neuroscience and the Global Brain Health Institute at Trinity, it was shown that there is a neurological link between respiration and focus. Studies show that breathing exercises can actually improve cognitive function, encourage positive thought processes, and reduce symptoms of anxiety.
Deep breathing exercises can have a profound effect on your state of mind, as well as improve the quality of your meditation practice. While allowing the breath to flow naturally throughout meditation is
encouraged, intentionally taking a couple of deep breaths initially can help ground the mind and create space for growth.
How to begin your breathing exercise, FREE audio/video clips to help you relax and sleep.
A Safer Online Experience for Kids
YouTube Kids
“Exercise is the Best Medicine for our Brain” by Dr. John Ratey
Expert Exercise Tips for Kids
Group exercise improves quality of life, reduces stress far more than individual work outs
Inside the Effects of Exercise: From Cellular to Psychological Benefits
Kids’ Brainpower Tied to Exercise, Sleep and Limited Screen Time
Movement and mental health: Behavioral correlates of anxiety and depression among children of 6–17 years old in the U.S.
National Library of Medicine
Physical activity in European adolescents and associations with anxiety, depression, and well-being
Noisy Learning: Loud but Fun Music Education Activities
Great k-12 lesson plans/activities
Story, Sonia, “What is Rhythmic Movement Training? “move*play*thrive Brain and Sensory Foundation
10 Benefits Of Exercise On The Brain And Body - Why You Need Exercise
American Psychological Association. (2013) Exercise: A healthy stress reliever. [Web page]. Retrieved from
Chekroud et al. (2018). Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: A cross-sectional study. [Web page]. Retrieved from
Klassen, Tricia (MSW, RSW) Trainer, Crisis & Trauma Resource Institute [Web page].Retrieved from
Millard, Elizabeth
Reynolds, Gretchen. 11 Minute Body Weight Workout with Proven Fitness Benefits [Web page]. Retrieved from
Sujain Thomas, “7 Benefits of Sport and Fitness Activities for the Elderly”
The Eight Part COVID Survival Tool Kit
Part VI: Sleep
The sixth tool in our to Covid 19 Tool Kit is sleep. To begin I would like to tell you my version of a Mullah Nasruddin story called “Raising Donkeys”.
Nasruddin decided he wanted to raise donkeys. He spoke to fellow merchants before he purchased his first donkey.
The donkey seller gave his advice about the care of donkeys and strongly recommended that the donkey be fed three bags of food a day.
Nasruddin as he walked away with his donkey thought, “three bags of food a day, bah, I am sure My donkey can get by on less and if I can save on the cost of the food soon I can purchase another donkey and in time have a cost-effective fleet of donkeys”.
Nasruddin, therefore, began feeding his donkey two bags of food a day rather than three.
Two weeks later a neighbor stopped by to see Nasruddin and his donkey and mentioned that the donkey was getting thinner. Nasruddin thanked him for admiring his donkey, wishing at the same time his neighbor would mind his own business. After all it was his donkey.
A month later when Nasruddin was feeding his donkey only one bag of food his neighbor stopped by again and remarked to Nasruddin that his donkey looked under the weather, perhaps ill. He seemed to have no energy and had sores all over his body.
Nasruddin told his neighbor that it was none of his business that his donkey was fine, and it was getting the work needed done.
Two weeks later his neighbor knocked on Nasruddin’s door and told Nasruddin that he saw his donkey in the yard and believed his donkey was dead.
Nasruddin looked out the window into the yard and said,” Too bad. If my donkey had survived just another week I could of have had him surviving on nothing “.
Driven by the needs of our culture we have come to ignore some of our basic biological needs and rhythms.
All living organisms require sleep. Patterns of sleep differ but adequate sleep is essential to health. The pattern of human sleep has evolved over millions of years to our environment, to the natural rhythms of light, darkness, and temperature.
During the last century with the introduction of electrical light, we have been become the only species to challenge our circadian rhythm and attempt to modify our need for sleep. In industrialized countries the belief is we can survive and thrive with less sleep and as a result we have become a sleep deprived and sleep deficient culture.
This sleep deficiency has profound consequences to our brain’s functioning and our physical, mental, and emotional health.
The Center for Disease Control (CDC) reports that 1/3 of US adults get less than the amount of sleep needed. Not getting enough sleep is linked with many chronic diseases and conditions such as type 2 diabetes, heart disease, obesity, and depression that threaten our nation’s health. Not getting enough sleep can lead to motor vehicle crashes and mistakes at work, which cause a significant injury and disability each year. Getting enough sleep is not a luxury – it is something people need for good health. (1)
I can think of no person to help educate us better on the importance of sleep to brain health than Matthew Walker Ph.D., a sleep scientist who has been in the forefront of investigating sleep and educating the public about the need for adequate sleep. His book “Why We Sleep “(2) is an international bestseller and contains a wealth of information about the need for sleep grounded in science.
I have read his book, articles he has written and watched many of his videos on the web. In the section of recommended readings and web resources that follows this narrative you will see his name appear often.
My recommendation, if possible, at this very moment is to consider stop reading this part of the newsletter and go watch his recent YouTube Google talk. (3) Matthew Walker’s Google Talk will take about an hour to listen to. You can then return informed by a great teacher on the discussion that follows.
I would also suggest a second YouTube presentation “Why Sleep. Matters”, part of Harvard’s Longwood Seminars, which is longer, is also valuable for watching later. The speakers in that presentation are Charles Czeisler MD, PhD, Robert Stickgold PhD and Judith Owens MD, MPH, all Harvard Faculty. (4) The introduction of the speakers is long, and you can skip to the lectures 6 minutes in. Judith Owen is the last presentation and addresses the importance and under recognition of the sleep shift in time when adolescents biologically are ready to go to sleep and the profound impact on learning and motor vehicle accidents causing disability and death caused by society’s denial of this shift. Her discussion of needing to advance the time school starts as an important public health issue that has been denied for more than a decade is essential watching.
When you watch them be sure you get a good night sleep later. The lectures are well worth watching again.
·      We spend one third of our lives sleeping.
·      Our brains which are 2% of our body weight consumes 20% to 30% of our energy reserves.
·      Our brains are busy and are hard at work all the time.
  • Adequate sleep allows our brains to heal, integrate the day’s experiences across many biological domains, to rest, renew, repair, and reboot.
  • Sleep provides preventive maintenance and is the platform for creativity.
  • Adequate sleep allows the brain to connect, recalibrate and integrate its functions.
  •  Each of the stages of sleep has been found to have specific tasks that allow us to clean out a chemical that drives sleep and to eliminate the accumulated metabolic brain toxins of the day.
  • Sleep allows our muscles and cardiovascular system to rest and reset and gives us the ability to process and integrate what we have learned in the day with our own brain’s personal history.
  •  Sleep allows us to store new learning and organize it to prepare for a more effective tomorrow.
  •  Sleep allows our bodies and brains to build resources to fight off infection and to protect us from chronic wear and tear and gives our body the ability to prepare new resources to combat infection and inflammation.
  • Sleep also can help us regulate our emotions. Adequate sleep is a healer.
We would be glad to hear your thoughts on what helps you sleep better.
Suggested Videos on Various Topics
A walk through the stages of sleep – sleeping with science a Ted series by Walker, Matthew.
Best viewed with Stages of Sleep listed below.
APOE4 allele linked with impairment of deep sleep and deadly sleep apnea. Walker, Matthew
Cognitive Behavioral Therapy Insomnia (CBT I)
Cognitive Behavioral Therapy For Insomnia: How To Sleep Better And Cure Insomnia
How Do Teenagers Sleep Differently? The importance of understanding the shift in the time of sleep onset for teens matters. Walker, Matthew
How much sleep do I need? Centers for Disease Control.
Learn how to sleep Correctly. Walker, Mathew. time 9:52
THE ABCs of ZZZs. Judith Owens. MD.
A talk devoted to a detailed discussion of adolescent sleep.
Sleep and sleep disorders. Centers for Disease Control.
Sleep Hygiene: How to Sleep Better & Treat Insomnia with
Cognitive Behavioral Therapy Insomnia (CBT I)
Stages of Sleep-non-REM, REM, Sleep Studies. YouTube Talk
How to get a good night’s sleep.
What’s the connection between sleep and Alzheimer’s? Sleeping with Science, a Ted series’s_the_connection_between_sleep_and_alzheimers_disease/transcript?language=en time 5:08
Why Sleep Matters | Matthew Walker | Talks at Google
“Why Sleep. Matters”, part of Harvard’s Longwood Seminars
Skip to about 100 minutes
Suggested Related Articles
Bollu, C. MD and Harleen Kaur MBBS. Pradeep C, MD. (2019).
A recent review of sleep medicine and medicines for sleep. Sleep Medicine: Insomnia and Sleep. Missouri Medicine, Jan-Feb, 116 (1): 68-75.
Koffel, Erin. PhD. Et al. (2018). Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I). [Web page} Retrieved from
Mattingly, Krisi, LCSW. (2019). How-to-make-sleep-a-priority. [Web page] Retrieved from
Owens, Judith, MD. Longwood Harvard series. Why Sleep MattersThe relation of inadequate sleep to motor vehicle accidents in adolescence.
[Web page] Retrieved from
Walker, Matthew. (2020). Sleep Loss, and the Socio-Emotional Brain
Trends. Cognitive Sciences, 24, (6),2020, 435-450
Walker, Matthew, et al. (2017). The effects of sleep a sleep deprived brain.
The Sleep Deprived Brain. National Rev. Neurosis, July; 18 (7):404-418.
Why Sleep Matters
Harvard Medical School Longwood Seminars. [Web page] Retrieved from
Apps to Help with Sleep
I have no direct experience with these apps.
Good Housekeeping Best Apps for 2021.
Somnus Therapy is an insomnia treatment program. Through CBT for insomnia, ACT and guided sleep meditations. We show you exactly how to sleep better.
CBT-I Coach by the US Department of Veteran Affairs
I would like to support Dr. McGuire’s observation that as a culture, we think we can survive and thrive with less sleep and as a result we have become a sleep deprived and sleep deficient culture. As usual I have broken down my research by age groups.
Debra Bratcher, NAMI Cape Cod and The Islands
COVID-19 Effects Quality Sleep During Lockdown.
In a survey of more than 70,000 people, only 7.7% now report their sleep as "very good," for example, down from 39.4% in March 2020.
Many factors could be driving this drop in sleep quality. Lead author Daisy Fancourt, PhD, and colleagues found people with lower household incomes, with a mental or physical health condition, with lower levels of education, and those from ethnic minority backgrounds were more likely to report "very poor" sleep quality.
"This could be due to a wide range of factors, such as disruption to routines and the changes in living circumstances that lockdown has caused," co-author Elise Paul, PhD, UCL senior research fellow in Epidemiology & Health Care, stated in a news release. This statement by Paul, PhD, supports Bruce Perry’s research that when structures/routines are not Predictable, Moderate and Controllable we are more likely to have increased feelings of anxiety and depression. These feelings interrupt our natural sleep patterns. However, COVID-19 is only a recent event added to the mix concerning sleep deprivation. 
sleep= better concentration, less risk for driving accidents
less irritable, more body control, better appetite
better manage health conditions
Here are two fun animated videos that explains to kids why we need sleep and what happens when we don’t get enough sleep.
Why Do We Sleep? The Dr. Binocs Show | Best Learning Videos For Kids | Peekaboo Kidz
What If You Stopped SLEEPING? | Dr Binocs Show | Peekaboo Kid
Teen brains want to stay up later and sleep-in later
Screen time is like putting our mind on a tread mill. It disrupts the sleep process.
It’s like running on the tread mill while trying to fall asleep.
Teen minds work fast. A nice clear connection is needed between bed and sleep.
If you are taking 2 hours to fall asleep, go to bed a little later and get up 15 minutes earlier. Keep getting up 15 minutes earlier until you are tired earlier at night. Do some boring activities before bed. Get some bright light exposure early in the morning.
Common Sleep Trends for Teens October 29, 2020
Young Adults
Many college students have difficulty managing their time and end up staying up late at night working on assignments and studying for exams. Little do they know the exact opposite is what they need for academic success. MORE SLEEP!
In fact, vast numbers of students are “sleep texting” and interrupting their sleep cycle. A common student belief, study more sleep less, has an adverse effect on memory formation and cognitive function. Furthermore, students are engaging in an extremely harmful practice of using prescription drugs to stay awake.
The following is an excerpt from The ADHD Drug Abuse Crisis on College Campuses
The abuse of Attention Deficit Hyperactivity Disorder, ADHD drugs on college campuses has reached epidemic proportions, according to the authors of a recent review in the Journal of Ethical Human Psychology and Psychiatry.  ADHD drugs, like Ritalin and Adderall, have become so commonplace on college campuses that students who abuse these drugs for studying, weight loss and partying are underestimating their risks. As a result, we have seen exponential increases in emergency room visits, overdoses, and suicides by students taking these drugs.
Sleep deprivation among college students
Louisiana State University Manship School of Mass Communication
Interrupted Sleep: College Students Sleeping with Technology | Elizabeth Dowdell | TEDx VillanovaU
The current practice in our culture is to work more, play more, study more. This practice has caused our nation to disrupt our natural sleep pattern. “People aren’t functioning fine with five or six hours of sleep. You really don’t adapt to that. Most adults need between seven and eight hours of sleep.”
How Much Sleep Do You Actually Need?
animated, good information 
Quality Sleep Extremely Elusive for Most During Pandemic, Survey Shows
Sleep and sleep problems to the 50+ population are unique from other age groups simply because their body chemistry and brain functioning has changed.
Sleep Problems in the Elderly
Some medical jargon but good information about sleep and the effects on a senior brain.
Best Treatment for Insomnia in Older Adults Dr. Nicole Didyk, MD
Easy listening with practical information advice about using prescription and nonprescription sleeping aids. Dr. Didyk gives advice to use Cognitive Behavioral Therapy-insomnia (CBT-i)
Karter, Justin. (2015). The ADHD Drug Abuse Crisis on College Campuses. [Web page]. Retrieved from
McNamara, Damian. (2021). Quality Sleep Extremely Elusive for Most During Pandemic, Survey Shows. [Web page]. Retrieved from
The Eight Part Survival Kit Series
Ways to Make Your Life Predictable, Moderate, and Controllable (Covid PMC)
Part VII-Nutrition

I would like to thank NAMI for the opportunity of sharing my thoughts about Bruce Perry’s COVID-19 tool kit. The seventh tool in the tool kit is nutrition. I am not a nutritionist or a chef or a food scientist. I am a person who enjoys shopping for food, helping to prepare the meal, sitting down at a common table, sharing the nutrition of both the meal, the conversation, and the company of others. I even enjoy the camaraderie of cleaning up. Many of my most cherished and nourishing memories in life continue to be those shared meals.

I would like to share with you two topics about food (nutrition) and physical and emotional wellbeing.

The first is the COMMON TABLE.

The collaborative problem-solving that developed out of cooperative foraging, hunting, and agriculture has been an essential ingredient of our survival. We have developed shared and innovative ways to find, store, and develop food resources. These skills and recipes for survival have been foundational in the development of our intelligences and collaborative skills and our recipe for success.

The celebration of these communal skills and their successes at the COMMON TABLE has become the essential to the

universal human rituals created around the sourcing, preparation and sharing of food.

Humans now live in every corner of the planet, from the Tropics to the Arctic, from the Amazon Rainforest to the Sahara Desert, from the plains and grasslands to the oceans of the world and in all these locations we have had the intelligence to find and harvest food resources.

For more than a year we have been unable to gather around the communal table because of the pandemic of COVID-19. These clearly have been difficult times.


Now through the collaborative effort of scientists throughout the world and particularly in the United States we have developed recipes for vaccines which are beginning to allow us to gather together around the common table.


I am now fully vaccinated as are the members of our family. On the weekend before Mother’s Day celebration, we gathered for a shared meal in Providence Rhode Island where my children grew up. We visited our favorite bakery in Barrington, had coffee at Aleppo ‘s in Providence, had an open-air meal near a farmers market and topped it off with an ice cream at Kow Kow’s. As we left the family sang happy birthday to my wife. It was a day that will be remembered and cherished by all.


Sitting at the family and community table, sharing food, , conversation ,companionship, and information in predictable, mostly moderate and controllable ways has been foundational in our survival and thriving.


I have generally covered in the discussion above about the foundational importance of sharing, sourcing, education, and preparation of food in our personal and ancestral history.


As in previous newsletters Deb Francis and I have gathered Web resources and annotated articles for you further interest on the Common table and the Microbiome.


The second topic of discussion I would like to approach is the role of diet, what we eat, and our physical and emotional well-being.


Reviewing this topic has been eye-opening for me and I hope what follows will be clear enough to you, interesting enough to you and digestible.


Over the past two decades health scientists have rediscovered the importance of what we eat to our health and to our Guts health and to the microorganisms that live on us and within us. We have been living with these organisms, called THE MICROBIOME for a long time. The relationship with these organisms is mutually beneficial. Over millions of years of living together we have established ecosystems, communities of living organisms with mutual benefits for all.

The soil, the oceans, all healthy living systems are richer, healthier, and more productive the more biodiverse they are, “having all different kinds of life in one area creating an interdependent web of life. Our guts (Gastrointestinal tract) , when biodiverse and healthy are a rich and essential source of nutrients that maintain the health and integrity of our bodies ,our guts and our minds. These diverse living organisms living within us and on us are central to our health.


The American diet over the past 70 years has been modified. Processed foods have taken essential nutrients out of foods and as a result the microorganisms in our guts do not have the raw materials for their survival or to produce essential nutrients for in the gut, the body and the brain.

Details of this “Web of life ecosystem are covered in some detail in the resources. Ones that I have found particularly helpful to me have been those of Robert Knight and Emeran Mayer on the Gut Microbiome.

Antibiotics in our lives and in our food have altered and shut down some of the bacteria and other microorganisms of the gut that maintain our health creating what is now called “leaky guts “that contribute to such diverse problems as inflammation, auto immune disorders, obesity, hypertension, depression, and anxiety.

Taking care of our minds means taking care of our guts and our diet.

Drew Ramsey’s suggestions about nutritional Psychiatry is where I started to gather thoughts about nutrition and mental health. There is evidence that the core foods that we need to eat to keep ourselves, our gut community, and our brains healthy.

Discussion on these topics in more detail is included in the web resources and articles listed below.


Jim McGuire

Did You Know?
Nutritional psychiatry is an emerging area of research specifically looking at the role of nutrition in the development and treatment of mental health problems.
According to the World Health Organization (WHO), depression could be one of the top health concerns in the world by 2030. Therefore, researchers continue to search for new ways to reduce the impact of mental health conditions, rather than relying on current therapies and medications. Nutritional psychiatry is an emerging area of research specifically looking at the role of nutrition in the development and treatment of mental health problems.
Why does nutrition have an effect on your mental health? The exact relationship between diet, inflammation, and alterations in mental health is not well-understood. Another possible explanation is that diet may affect the bacteria in the gut, which people often refer to as the gut microbiomeOngoing research has found a strong link between gut health and brain function. For example, healthy bacteria in the gut produce approximately 90% of the neurotransmitter serotonin, which affects mood. Furthermore, early research shows a potential link between a healthy gut microbiome and lower rates of depression. As diet plays a major role in the health and diversity of the gut microbiome, this theory is a promising explanation for how what we eat may be affecting our mental well-being.
Ø Brain growth and its development can be influenced by the food we eat.
Ø Food is a language that speaks to our genes.” Jeff Bland
Ø You can’t have good brain health without good gut health.
Ø When families eat together, young children are more likely to prefer healthy meals and less likely to be overweight or obese.
Ø Scientists have found that when parents converse with their children during meal-times, the child is more likely to know and use more words than average.
Ø Mealtimes also provide a good opportunity to help the child respond to bullying and to monitor the situation.
Ø Parents and children are more honest and open with each other. Children felt that they could share their problem with their parents and turn to them for advice and support.
When family dinners are not helpful
If the mealtime becomes a time when parents scold children or criticize them; family dinners can hurt the parent – child relationship rather than help it along. If children see their parents fighting at the table, they are more likely to be distressed. If they watch television instead of talking to each other, most of the benefits of family dinners are nullified. 
Psychological Benefits of Family Meals Gauri Sarda-Joshi 
Ø Teens are more likely to be emotionally strong and have better mental health.
Ø They are more likely to be emotionally strong and have better mental health.
Ø Regular family meals (usually dinners) are associated with reduced incidence of drug and alcohol use by the teens.
Ø Regular family meals are also linked to a lower chance of future drug use once the teens leave home for further studies or work.
Ø  Public education on the benefits of family mealtime is recommended. Health professionals and social service professionals working with adolescents and their families should be informed of the benefits of family meals in order to educate their clients. These professionals should also be cognizant of barriers faced by families and work toward a gradual increase where necessary.
Ø Changes in policy (such as requiring after-school activities to end by 6 PM) or in social norms (such as the expectation of 9-to-5 workers in some sectors to consistently work late) may allow more parents and students to be home together in the evenings and facilitate regular family meals.
Young Adults
Mealtimes are also an opportunity for young adults to interact with each other and to build their community ties with friends. Taking a break to focus on meals also helps to refresh our mind; so we are more productive when we get back to studying.
Ø Greater frequency of family meals was associated with significantly lower odds of the following variables: cigarette, alcohol, and marijuana use; low grade point average; high depressive symptoms and suicidal ideation (among boys and girls); and poor self-esteem and suicide attempts among girls.
Ø Studies found that family mealtime to be a potentially protective factor in the lives of adolescents for nearly all of these variables, particularly among adolescent girls. These associations held even after controlling for family connectedness, which provides additional evidence suggesting that eating meals as a family has benefits for young people above and beyond their general sense of connection to family members and that these benefits may apply to a broad range of health domains.
4 essential lifestyle factors to maintain optimal brain function. An easy way to remember them is with the letters E-A-S-Z:
1.    EAT healthy food. (non-processed)
2.    ACTIVATE your body and your brain.
3.    Manage STRESS through mindfulness.
4.    Get plenty of restful sleep (Z’s).
Healthy eating is essential for memory, mood, and focus — the brain uses more than 20% of our caloric needs. Research studies have found that processes that happen inside of our bodies that lead to Alzheimer’s and other forms of dementia begin years before noticeable symptoms begin to appear. These processes include chronic inflammation of brain cells and blood vessels when our bodies break down unhealthy foods.
More recently, a study looking at adults over the age of 50 years found a link between higher levels of anxiety and diets high in saturated fat and added sugars. Interestingly, researchers have noted similar findings in kids and teenagers. For example, a 2019 review Trusted Source of 56 studies found an association between a high intake of healthful foods, such as olive oil, fish, nuts, legumes, dairy products, fruits, and vegetables, and a reduced risk of depression during adolescence.
Mealtimes for the Elderly
Recommended Readings/Viewing
EatingWell Magazine
Eat to Beat Depression and Anxiety with Drew Ramsey, MD time 1:14:20
6 psychological benefits of family meals Brain Fodder
Meal Times for the Elderly
Lipps, David M.D. Kaiser Permanente. 2019 (17, October). How the food we eat affects our brains and bodies.
McGrane, Kelli, MS, RD . 2021 (8, January). Follow Your Gut: Microbiomes and Aging with Rob Knight - Research on Aging. time 56:02
Ramsey, Drew M.D. Nutritional Psychiatrist Shares Diet Mistakes that Cause Depression and Anxiety. [Video] Time 45:57
Sarda-Joshi, Gauri. Six Psychological Benefits of Family Meals [Video]