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:/