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How to Handle Anxiety Over Back-to-School Decisions - The New York Times

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A combination of dread, panic and sheer exhaustion. This is what I see on the faces of patients (and friends and colleagues) when the conversation turns to the most pressing topic on every parent’s mind: what to do about school in the fall.

I’m a psychiatrist specializing in women’s mental health, and I have yet to speak to anyone who feels satisfied with the options presented to them, or who feels particularly confident in the choices they’ve made.

The information on children and the coronavirus has been evolving since March, with the most recent data suggesting that children are less likely to become infected by the virus and less likely to have a severe course when infected. But, those words “less likely” suggest that children are at some, albeit smaller, risk. And, the United States still has not come up with an adequate solution to protect teachers, many of whom are high risk.

As I see it, school stress for parents boils down to two main points: Deciding what to do, and then what to do with the uncomfortable feelings that could arise after that decision. As a psychiatrist, I’m admittedly not so helpful when it comes to the decision of whether or not to send your kids to in-classroom learning this fall. Where I can help is how to deal with the uncertainty and difficult feelings that accompany this process.

A risk assessment system, like the one described by Emily Oster, Ph.D., a professor of economics and public policy at Brown University, can be a useful guide when making decisions with scarce data. Instead of focusing on the illusion of “one right answer,” this framework can give you a reliable process for making hard parenting decisions by focusing on evaluating and mitigating risks, and assessing benefits. While no parent is feeling particularly confident about the school options available to them, it is possible to feel good about the process you use to make those decisions.

In an interview, Dr. Oster wrote, “By making clear the choices, the costs and benefits, we can reason our way to better decisions. But I really think even more important is the fact that we can make our way to more confidence in these decisions by articulating a good process.”

Once you’ve delineated a plan, then you’re faced with the task of coping with the onslaught of feelings, like worry, guilt, fear and uncertainty. For this, here are some strategies, many of which come from acceptance and commitment therapy, a form of behavioral therapy that teaches people to accept their difficult thoughts and feelings as opposed to struggling against them, and to prioritize taking actions that are in line with their values.

Part of healthy emotional coping during a pandemic is to accept that you will feel conflicted about the decisions that are in front of you. The truth is that even your pediatrician can’t make guarantees or promises.

Rachel Pearson, M.D., Ph.D., an assistant professor of pediatrics at UT Health San Antonio, part of the University of Texas system, said: “I wish so much that I could give parents certainty. I wish so much that there was abundant solid data that I could point to saying this is how we’re going to keep the kids safe and our community safe.”

It’s helpful to remember that in times of chaos, the dogged search for certainty can itself lead to distress. Dr. Pearson pointed out that the goal is not to guarantee that your child will never be exposed to a virus particle. That is impossible. The goal is to make a realistic plan that will holistically keep teachers, families and children as safe as possible.

Spending time considering how you will navigate the logistics of blended learning come fall is productive if you are engaged in problem solving and making concrete decisions. Ruminating about the social distancing precautions each family in your kid’s school is taking is less productive, for you don’t have any control there. Especially in times of uncertainty, it’s seductive to believe that if you worry about something for long enough, you can affect the outcome, but this is a fallacy.

Many of my patients are coming to me asking how they can get rid of that nagging feeling that they aren’t make the right choice for their kids. I’m sorry to be the bearer of bad news, but that’s not how feelings work. You can’t just turn them off.

To be a parent during a pandemic is to be worried and uncomfortable. But the good news is that it’s not the worry itself that’s the problem, it’s what you do with it. When those unproductive worries or overwhelming feelings arise, do you let them drag you down into doomscrolling or reassurance seeking? If you fall into these habits, practice getting space by doing daily exercises to create psychological distance.

One strategy for distancing is called defusion. The goal is to avoid being “hooked” by any one thought or feeling, and instead to view yourself as an observer of your mind. You can imagine that your thoughts are like leaves, floating down a stream, or like plates of sushi, moving along a conveyor belt. When your mind starts moving into the slippery slope of unproductive worries, try naming them: “There goes my mind again.” This highlights the difference between “having a thought” and “buying a thought.” When unproductive worries strike, you don’t have to go down that rabbit hole of trying to disprove them or reassure yourself, you can just let them be. It’s not bad feelings or thoughts that are the problem. It’s what we do with them that causes more suffering.

Instead of spending time chasing certainty and second-guessing your decisions, work on being self-compassionate; nurture a sense of good will toward yourself for facing this hard decision. Monitoring your self-talk is a key component of self-compassion. Are you holding yourself to an impossible standard by trying to predict the future? Are you blaming yourself for a situation that is completely out of your control? Let go of self-judgment and try developing some positive self-talk, such as: “I’m making the best choice for my family with the information I have” or “this decision works for us and our level of risk tolerance.”

For some parents, their grief and guilt around a lost school year has morphed into obsessive researching or catastrophizing. It can be less confronting to rage over the prospect of more home-schooling than to let yourself feel the sadness of your child not getting to have a full kindergarten experience. Recently, one of my patients broke down crying because she wouldn’t be able to see her son’s pre-K classroom, and that he wasn’t allowed to decorate his cubby. We realized that her grief was masquerading as anxiety, and once she let herself feel that sadness she felt some relief.

Many parents haven’t yet heard about what’s happening at their children’s schools for the fall. Others have been told schools are reopening with remote learning or some in-classroom work, but this is subject to community virus levels, and how social-distancing measures can realistically be implemented. Psychological flexibility refers to one’s ability to recognize and respond to changing demands in real time. A study conducted during the pandemic found that people with a low capacity for flexibility are at higher risk for mental health issues.

Psychological flexibility is a skill that is worth honing for parents in particular, experts say. One way to nurture flexibility is to reflect on other situations in your life when you’ve been faced with uncertainty and unexpected change. What helped you get through those times? What did you learn about yourself?

Instead of thinking about the ways in which the upcoming school year may not measure up, or what your family has lost, connect with your values. If you weren’t worried or ruminating about the school year, what else could you be doing?

Five years from now, how would you like to have shown up for your family during the pandemic? How do you want your children to remember this time? Put your energy into what’s working and what’s meaningful to you.

One of my patients will be sending her son to prekindergarten in a classroom with 10 other students. She already knows five of the families, and has been doing social-distanced play dates in preparation for the fall. Instead of ruminating about the five families she doesn’t know, my patient is actively focusing on how happy to her son is to be with friends. While not all families have the luxury of a small class size, taking positive action forward in a way that is aligned with your values helps take your mind off the lack of control and certainty.

When it comes to parenting, every risk feels too big. The global pandemic has only intensified what parents everywhere have long known: Parenting is an exercise in surrender. Developing these coping skills will not only help you to buoy yourself during these uncertain times, they’ll also serve you well into the future.


Dr. Pooja Lakshmin, M.D. is a perinatal psychiatrist specializing in women’s mental health and a clinical assistant professor of psychiatry at George Washington University School of Medicine. She is working on a book about the tyranny of self-care.

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How to Handle Anxiety Over Back-to-School Decisions - The New York Times
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