God and COVID-19

This past week I've read alot of  "theological" statements positing ideas about God during this global pandemic. Some of them just made my head spin as the theology inherent in these statements is full of holes and presents an image of God that is the antithesis of my understanding and experience of God whose own self definition is love. For example,  I read a statement from a physician a few weeks ago that said he didn't care about the lack of personal protective gear that our profession faces right now because God "won't let that happen to us." I read another statement that linked the timing of the spread of the virus to Lent as a way to increase our suffering and bring us closer to Christ. Goodness gracious.

The fact is that people have argued for thousands of years about where God is when bad things happen. And the bottom line is that there is no good, comprehensive answer.

James Martin, a Jesuit priest, wrote an opinion piece for the New York Times last week. In this piece he raised the following points (to read the full article click here):

• When we address the "problem of suffering" a distinction must be made between  natural suffering (such as hurricanes, cancer, and yes, this virus) and suffering that results from the actions of individuals. 
• All explanations for natural suffering in the end are "wanting in some way." Most common explanations include that suffering is a test (which Martin states is an approach that can make God out to be a monster) and that suffering is punishment for sins. 
• The confusion for believers comes down to the "inconsistent triad" which he summarizes as "God is all powerful, therefore God can prevent suffering.But God does not prevent suffering. Therefore, God is either not all powerful or not all loving. "
• The most honest answer to why COVID-19 is killing people is we don't know.
• Jesus' fully divine and fully human nature, biblical teachings on sickness and  healing,  and  of course prayer can bring comfort to Christians at this time.
• Those who do not consider themselves Christians can also view Jesus' life and actions as a model for care of the sick, that we should allow our heart to be "moved by pity" in our response to how we care for others during this crisis. 

Over the years I've thought alot about natural suffering. I see my patients who through no fault of their own have dopamine imbalances in their brains and thus live their lives with schizophrenia. I look at the ravages of the Paradise Fire and other natural disasters. And now this virus, the ultimate impact that we don't yet know.

While my beliefs essentially align with the above, I've often wondered about what role free will plays.  In seminary our theology professor wrote out several different areas that different theologians view as a continuum for ways of conceptualizing God. For example, some see God as a master clock maker, who brought the world into being and continues to control every aspect. The other end of this continuum is God created the world and then stepped back, letting creation evolve--a more hands off approach. The professor presented at least a dozen of these different areas, but one that especially intrigues me is free will vs. determinism. Do we have the ability to make our own choices, or is God determining every step? (For a full discussion of free will click  here). In my own thoughts, I've often wondered if nature itself has free will. What if free will did not only apply to people but to the natural order?  Can a virus' mutation be explained by the free will of the natural order? Can ultimate neurological function be explained by  the free will of  the developmental process? I am far from a theologian and will leave it for deeper spiritual thinkers to ponder, but it is something I've always been curious about. Maybe we limit the concept of free will if we only apply it to humans...

For now dear readers, stay calm, wash your hands, stay at home,  pray if so inclined, and care for each other with a heart driven by love...

Calming activities during the time of COVID-19 and the best banana bread recipe ever...(yes, they are related)

In last week's post I shared some coping mechanisms for worry. One of the mechanisms to use when worry translates into tension/anxiety is to engage in activities that calm you and distract you from your anxiety producing thoughts. In that post I suggested several activities. Activities such as: 

• Yoga:  for some now free yoga classes click this link to  Core Power Yoga
• Fitness:  Planet Fitness is live streaming a daily workout at 7 PM ET on their Facebook page, to join in click here. Orange Theory (my absolute favorite gymn ever) has daily at home work outs. For the March 22 video click here. 
• Journaling
• Prayer: for a prayer in the time of COVID-19 from the Anglican Church in Ireland, click here
• Art projects: Michael's has a page that lists several make at home projects. They are also currently offering 30% off supplies for on line or curb side pick up. Click here for more information. 

This past week I found myself turning to one of my go-to coping mechanisms--stress baking. We have three generations together right now isolating in my home, and I've found myself turning to baking as a distraction when my worries start to become overwhelming.  This morning I made banana bread--it's a family recipe that my grandmother gave me when I got married. If you find baking calming and you have bananas that are starting to brown, consider heading to the kitchen. You could even make a double batch and share with someone else, even a neighbor you haven't met. 

Ethel's Banana Bread

2 cups mashed bananas (usually about 3-4)

3 eggs

1 cup oil

1 teaspoon vanilla (not mandatory if you don't have it)

2 cups flour

1 cup sugar (can use less if desired)

1 teaspoon baking soda

1/4 teaspoon salt 

Optional ingredients: 

grated lemon or orange peel 

dried or fresh fruit cut in small pieces (about a handful--I use cranberries or blueberries)

chopped nuts (about 1/2 cup)

1 teaspoon cinnamon 

Wash your hands thoroughly. 

Preheat oven to 350 degrees. 

Mix the sugar into the oil  and let sit a few minutes, stirring occasionally. Then add bananas, eggs, and vanilla. Mix well.  Add  flour,  soda and salt to the mixture. Stir to combine. Stir in any of the optional ingredients if desired. 

Grease (or use cooking spray) a 9x5 loaf pan. It comes out best if you line the pan with greased/sprayed wax-paper. Bake for about 50 minutes. Insert a knife into the center and if it comes out without batter stuck to it, it is done. (I like to leave the very middle a little gooey). 

Enjoy!

Ways to cope with worry during a pandemic

The topic of this week's post is physical and mental health. 

Each day the news about COVID-19 becomes more worrisome. The spread, risks, and ripple effects  are alarming, and certainly cause for worry. And some worry is a good thing--it can drive us to make the hard changes that prevents/slows the spread of this new virus. But there is such a thing as too much worry---and too much worry can take a toll on both our mental and physical health. 

A lot of my time right now is focused on learning and implementing cognitive behavioral therapy techniques with my patients. In this week's post I want to share some cognitive behavioral strategies that can help people who might be worrying a little too much. The information is adapted from the American Academy of Family Physicians. 

On the left side of the chart below are some problematic thoughts/beliefs that people can have about worry. In the middle of the chart are some facts that counter that thought. In the third column are some strategies/behaviors you can turn to if you catch yourself falling into one of the problematic thoughts. 

PROBLEMATIC THOUGHT/BELIEF  ABOUT WORRY	COUNTERING FACTS	SUGGESTED COPING STRATEGIES
If I'm worried it is a warning.	Worry rarely saves us from anything. Most things we worry about are unlikely events. The bad things that happen to us are rarely anticipated through worry and rarely allow us any control. A compelling worry is still just a thought that will pass.	Challenge your distorted risk assessments: “Am I overestimating the risk?” “Yes, it feels likely, but how likely is it really?” Remind yourself about the transient nature of worries: “What will this situation be like in year,  or even next month?”
I need to seek re-assurance for my worries.	Frequently seeking reassurance (e.g., searching the Internet, checking your body/temperature constantly, repeated consultations with health care professionals) often stimulates more worry and doubt. The brief relief provided by reassurance only perpetuates the worry cycle.	If you repeatedly seek reassurance from others, encourage them to gradually withhold the reassurance that only perpetuates the problem. Stop “investigating” on line.  Getting the facts from trusted sources is fine, but spending hours reading information on questionable web sites is less than helpful. Checking your temperature if you feel feverish is important, but doing so incessantly should be avoided.
I have to avoid thinking about my worries.	Trying not to think about a particular thing is the problem, not the solution. What we resist persists. We think about what we are striving not to think about. Do not try to eliminate your worries. Worried thoughts can be accepted as background noise without being actively engaged.	Learn mindfulness meditation. It is simple, but not easy. Learning to be in the moment, focusing on your breathing and accepting the contents of your thoughts, can gradually ameliorate worry as you become more skilled.
I need to give my worries immediate attention	This only perpetuates the worry cycle. Strive to experience your worries “on the clock” rather than whenever they intrude and upset you. You can learn to have worries on your schedule rather than having them intrude on you all day.	This only perpetuates the worry cycle. Strive to experience your worries “on the clock” rather than whenever they intrude and upset you. You can learn to have worries at your bidding rather than having them “chase” you all day.  Some people find it helpful to keep a small box handy to "put their worries in" until they want to give them their attention.
If I worry I can  control what worries me and the future will be certain	More worrying will not yield control or certainty. If a worried thought is truly a signal, it should dictate certain actions. If a worry does not call for action (other than reassurance seeking), it is likely to be merely noise, not a signal.	More worrying will not yield control or certainty. If a worried thought is truly a signal, it should dictate certain actions. If a worry does not call for action (other than reassurance seeking), it is likely to be merely noise, not a signal.
My worries are leading my body to feel tense and anxious.	When you give credence to your worried thoughts, your body will respond with tension, anxiety, and somatic symptoms. When you accept worries as “just thinking,” your body will respond accordingly.	Relaxation and diaphragmatic breathing skills can help decrease body tension.  Discover what calms you, (examples include massage, yoga, exercise, music, a hot bath, journaling, prayer, giving your time to someone or something).
If I worry it is a sign of weakness or lack of faith	Worries are not the litmus test of strength or religious faith. All people are prone to worry. However, unhealthy habits perpetuate worry, and healthy habits can diminish worry.	Give a worried thought your full attention for five minutes, but then do something physical or interpersonal instead. Exercise and social contact (while not seeking reassurance) usually make worry much less compelling.

New Cognitive Behavioral Therapy group starting in Reno!

The focus of this post is mental health. 

Experiencing symptoms of depression?

Consider joining a Cognitive Behavioral Therapy (CBT) group designed to help people like you!

What: CBT is an evidence-based form of therapy that is based on the theory that people’s emotions, behaviors and physiology are influenced by how they think about events/situations. The first CBT group will help participants to look at how thoughts affect mood. The group will be led by Philip Malinas, MD and Suzanne Watson, MD.

Where:      Office of Philip Malinas, M.D. and Associates

                    639 Isbell Road, Suite 380

                    Reno, Nevada 89509

When:       Wednesday evenings, from 6-8PM

The first group begins on March 18 and meets weekly for four sessions. There will be an opportunity to meet for up to 12 additional sessions (focusing on how activities, interpersonal relationships and health affect mood) but there is no requirement to continue past the first four sessions.

Cost:          Insurance accepted (participant responsible for co-pay)

                    Self-pay patients pay $175 per session

Who can attend: Anyone who is experiencing symptoms of depression who is already established with a mental health provider.

For more information or to register contact Monica at office@malinasmd.com or at 775.440.1520

Sign up today, space is limited!

40 days to more abundant life

This week's focus is on spiritual health. 

I know that when I post on spiritual health a lot of readers immediately click away. It's a risk I take by having a tripartate blog that includes spiritual health, especially in a world that likes to keep the spiritual distinctly separate from all things scientific. But before you click away, pause for a moment and think about what it might be like to focus intentionally on creating a more abundant life for the next 40 days. Below are some of the messages and practices of Lent which I believe can be helpful to anyone:   

Remember your mortality,  the transient nature of life, and that none of us lives forever.  February 26 was Ash Wednesday, where in some Christian traditions ashes are placed on people's foreheads. The ashes are a sign of penitence and mortality, and  a remembrance that it is through Christ that we are given everlasting life. When the priest places the ashes on a person's forehead, they say, "Remember that you are dust, and to dust you shall return."

We all came from nothing, and we will return to that nothing. This thought helps us remain humble, keep things in perspective, and reminds us that we don't have forever to do the things we want to do in this life (including  contributing in some small way to make our corner of the world better, chasing that dream, spending time with those we love, and making amends to people we have wronged). 

Fast and abstain.  Lent is a time of fasting and abstinence. The bible is full of examples of fasting, and reasons to fast. There are different types of fasts--from fasting from all food entirely, to partial/intermittent fasts. We might also consider abstaining from certain foods (high fat foods, sugar, meat, or non-local foods) or substances (such as alcohol, tobacco, cannabis, street drugs, or caffeine) over the next 40 days. Christians who fast seek to draw closer to God through prayer and greater clarity of mind during fasts/times of abstinence. Yet anyone can benefit from stepping back and becoming more intentional about food and substance intake. 

Make amends for the ways we fall short. Penitence, the act of feeling/showing regret for one's sins,  is a big part of Lent in the Christian tradition. In Ash Wednesday services Episcopalians prayed a long prayer of penitence. Parts of this prayer can be helpful for anyone and can be used almost as a checklist. Look at the areas below and take stock of your own life--do you have regrets about any of these areas? Do you need to change your behaviors? Do you need to reach out to someone and say I am sorry?

1. Not forgiving other people
2. Displaying pride, hypocrisy, and impatience
3. Being self indulgent
4. Exploiting other people
5. Envying other people
6. Loving worldly goods and comforts
7. Dishonesty in daily life and work
8. Negligence in prayer/worship
9. Blindness to human need and suffering
10. Indifference to injustice and cruelty
11. Making false judgments
12. Thinking uncharitable thoughts 
13. Being prejudice 
14. Wasting creation and showing a lack of concern for those who come after us

Prayer and time for centering:  Prayer is a big part of Lent. Making time daily to draw closer to God  is important. Additionally,  daily time for meditation, journaling, art --anything you find centering--is very helpful for improving mental health.  If you'd like to see what short, focused daily prayer is like for the next 40 days, an on line resource that focuses on pausing, listening, thinking and praying can be found by clicking here.

I close with a prayer written for Ash Wednesday: 
Almighty and everlasting God, you hate nothing you have made, and you forgive the sins of all who are penitent: Create and make in us new and contrite hearts, that we, worthily lamenting our sins and acknowledging our wretchedness, may obtain of you, the God of all mercy, perfect remission and forgiveness; through Jesus Christ our Lord, who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.