Home Q&A with Joe D’Ambrosio: Strengthening Mental Health During the Pandemic

Q&A with Joe D’Ambrosio: Strengthening Mental Health During the Pandemic

Physical isolation and social distancing have become the new normal amid the COVID-19 pandemic, and strengthening psychological coping is as important as staying physically well.

In this Q&A, University of Louisville Trager Institute and Republic Bank Foundation Optimal Aging Clinic Director of Wellness, Joseph G. D’Ambrosio, PhD, JD, LMFT, CSW, shares his thoughts on the human need for connectivity, and ways to improve mental health during this unprecedented time in our history. D’Ambrosio also is an assistant professor in the UofL School Medicine.

 1. Talk briefly about the human need for social connectivity.

While we may want to think of ourselves as an “island” that can sustain itself, several decades of research has linked positive human social connection to health, well-being and survival. High social connection results in the following benefits:

  • Fifty percent increased chance of longevity
  • Stronger gene expression
  • Lower rates of anxiety and depression
  • Higher self-esteem and empathy
  • Increased emotional regulation skills
  • The creation of a positive feedback loop of social, emotional and physical well-being

Social connection has been defined as a “person’s subjective sense of having close and positively experienced relationships with others in the social world.” The need for social connection was theorized in 1943 by Abraham Maslow who posited that when basic psychological and safety requirements are met a person’s primary psychological need is a sense of affectionate and loving connection to others. While different disciplines in academia have their own twist on the definition almost all agree that it is a subjective sense of connection based on one’s perception and results from the accumulation of past and present experiences.

We tend to know when we have social connection and when we don’t. For example, many of my clients who are experiencing marital difficulties and are living with their spouse tell me that living with and sleeping next to a partner who is disengaged and not socially connected is the loneliest feelings that one can imagine. Social contact is not enough to sustain oneself or reap the benefits of social connection. As humans, social connection is of crucial importance to human life and something that we all should strive to nurture and increase in our lives (Seppala, Rossomando, & Doty, 2013; Yen, Shim, Martinez, & Barker, 2012)

2. The longer we are in physically isolated, the more difficult this seems to become. Speak to this, please.

As social beings we are meant to be in community and continued self-isolation increases the risk of psychological distress, dysfunctional interpersonal behavior, accelerated mortality and increased loneliness. Research has found that low social connection causes the following:

  • Low social connection is more dangerous for your health than smoking, high blood pressure or obesity
  • Higher levels of inflammation at the cellular level
  • Higher susceptibility to anxiety and depression
  • Slower recovery from disease
  • Increased antisocial behavior and violence
  • Suicide (Seppala et al., 2013)

During this period of physical isolation, we have to be on guard to monitor our feelings and emotions, and ensure that we maintain as many social connections as we can. Reach out and connect with someone today either by phone, email or text. If you are living with someone reach out and tell them how amazing they really are and watch their face shine!

3. We've heard about the importance of keeping children on a schedule with their now home-school work, etc. 

Children love routines because they give them a sense of safety and security. When a child’s routine is predictable it gives them a way to organize their lives and develop confidence in both themselves and the world around them. When a child experiences uncertainty it increases stress and feelings of helplessness. The more we can support them by maintaining routines or creating routines that they can count on and look forward to, the better a young child will be. A young child’s brain undergoes constant development as they grow. Routines help the part of a young child’s brain that is able to plan ahead and make predictions about the future.  Having routines in place gives young children the space to feel good about themselves as they know what is coming and understand they can accomplish the tasks presented.

4. Many parents are now juggling working at home, teaching and keeping their children moving forward with school and trying to stay sane themselves. What other advice can you give to families?

During this time, it is even more important than usual to establish routines for children. Here are some tips that work for many of my clients:

  • Plan a specific time to awake and go to bed, do schoolwork, perform house chores, play, eat, exercise, and have family time.
  • Develop a specific time for children to spend by themselves either drawing or reading
  • Create a bedtime ritual, if you don’t already have one.
  • Work with your children to make pictures or signs for each activity that they can see and count on happening.
  • Be sure to let children know when the next routine is about to happen so that they can be prepared for example, “we have 15 minutes left of study time so that we can take an exercise break.”
  • Use a dry-erase board or poster to post a daily agenda that includes reading time, playtime, naps, etc.
  • Assign chores to your children. Even children as young as 3-years-old enjoy sharing adult responsibilities.
  • When preparing meals include children in the preparation, even if it is something small.
  • Encourage video-chatting using with family and friends. Two children drawing together while on a video-chat can be fun, and give the children a chance to connect.
  • Help your children to become artists by using old magazines, wrapping paper and mail advertisements to make collages.
  • Encourage independent childhood play time. Parents don’t have to be with the kids 24/7, and the separation is a great way to help children differentiate from their parents. That is a skill they will need to get through the rest of their lives!

Try not to be too rigid, if you go off schedule one day it will not be the end of the world. Just be sure to confirm that tomorrow you are back on the schedule. Most importantly, be kind to yourself and your children. These are stressful times and flexibility may be your biggest ally (Education.com, 2020; Wired.com, 2020).

5. It can really weigh on your mind when a loved-one gets sick with COVID-19. What advice do you have for the caregivers?

Caregiver stress is relevant in normal caregiving but with the COVID-19, we are finding that caregiving is even more stressful because of the risk of the caregiver getting sick. If you are caring for a loved one with COVID-19, according to the CDC, monitor the patient for emergency signs that include trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face. If possible, have them use a separate bathroom, avoid sharing personal household items like dishes, towels, and bedding. If facemasks are available, have them wear a facemask when they are around people, including you. If the sick person cannot wear a facemask you should wear one while you are in the same room with them, if facemasks are available. If the sick person needs to be around others (within the hone, in a vehicle, or doctor’s office) they should wear a facemask. Wash your hands often with soap and water for at least 20 seconds, especially after interacting with the sick person. If soap and water are not readily available, use a hand sanitizer that contains at least 60 percent alcohol. Cover all surfaces of your hands and rub them together until they feel dry. Avoid touching your eyes, nose and mouth. Every day clean all surfaces that are touched often, like counters, tabletops, and doorknobs by using household cleaning sprays or wipes. Wash laundry thoroughly and wear disposable gloves. Keep any soiled items away for your body while laundering. Be sure to wash your hands immediately after removing gloves. Also, avoid having any unnecessary visitors.

Most importantly, stay connected with your loved one who is ill by using your phone and doing something they would like such as playing their favorite music in the house or apartment, telling jokes via text, singing them a song outside their room or cooking their favorite meal and leaving it in front of their room. Be creative and help each other get through this rough time (The Centers for Disease Control and Prevention (CDC), 2020).

6. What new lessons are we already learning from a mental health standpoint?

I have found that every crisis has a lesson to offer. One of the big lessons I have learned is that life is finite, and we should really be deliberate and intentional in living the life that we want to live. So many of us live a life that was prescribed by either family, society or our own beliefs about what we should do to be successful. Many times, the forces that compel us to live life the way we think it should be lived don’t really allow us to be happy or as prosperous as we could if we were doing what we really want to do. I find that in crisis we have an opportunity to stop and reevaluate who and where we are, and determine if this is who and where we want to be in the future.

7. This country has faced many difficulties including the Spanish flu of 1918, war times, the Great Depression, etc. It seems like this is the time of our generation to now rise up. These challenges take a great deal of mental fortitude. Comment on this idea, please. 

Living in uncertain times causes a lot of stress and anxiety. This pandemic is particularly stressful because of the uncertainty that is creates in our lives. So many are uncertain on how to protect themselves and seem to be waiting for something bad to happen to them. Luckily, the chance of getting COVID-19 is low but the fear is still out there 24/7 in the news. Follow the advice of the professionals, but also use your common sense and do those things that make you feel safe. Having an understanding of the disease is good so that we can protect ourselves, but we have to remember that this too shall pass, and we shall be stronger because of it. Past generations have risen up and used crisis to improve the world and we can do the same.

8. What additional thoughts and advice can you offer?

One of the big challenges that I see in my clients is the inability to deal with uncertainty. The lack of control over this disease has confronted so many with how little power we have over our lives. Yes, we eat healthy and exercise and take care of our bodies but when something like this occurs, we are confronted with our mortality. I find that in times like this it is important for us to begin to contemplate our lives and look introspectively at who we are and how we want to truly live our lives. This is a great time to start a mindfulness practice. Commit to five minutes in the morning and five minutes at night to silence and contemplation. Increase the time commitment daily so that you are doing at least 20 minutes twice a day. It will help you, and will help situate you in the world where you can be your best self. There are many free apps available such as Insight Timer or Calm that can help.

Another thought is that we learned that COVID19 is most troublesome for people with chronic diseases. Now is a good time to begin to live a healthy lifestyle. For many that means changing your diet to include more fruits and vegetables and less meat and dairy. Work hard to make your body as immune proof as it can be.

Most importantly, have compassion for yourself and those around you during this period of time. We forget what a little bit of shared love can do to change ourselves and the world. It doesn’t take much to say, “I love you.”



Education.com. (2020). Routines: Why they matter and how to get started,  https://www.education.com/magazine/article/importance-routines-preschool-children/.  

Seppala, E., Rossomando, T., & Doty, J. R. (2013). Social connection and compassion: Important predictors of health and well-being. Social Research: An International Quarterly, 80(2), 411-430.

The Centers for Disease Control and Prevention (CDC). (2020). Interim guidance for implementing home care of people not requiring hospitalization for coronavirus disease 2019 (COVID-19).

Wired.com. (2020). How to entertain your young children during a quarantine, https://www.wired.com/gallery/how-to-entertain-children-quarantine/.

Yen, I. H., Shim, J. K., Martinez, A. D., & Barker, J. C. (2012). Older people and social connectedness: How place and activities keep people engaged. Journal of Aging Research, 2012(1-10).

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