Finding connectedness and promoting mental health during COVID-19: A video-sharing group

Introduction
The COVID-19 pandemic has made it increasingly difficult for people to connect due to physical distancing. This has had a negative impact on people’s mental health, both at the individual and community level.[1,2] These deleterious effects may not resolve when the pandemic is over; some research has suggested there will be long-lasting effects.[2] Physical distancing has also been shown to exacerbate symptoms for people living with pre-existing psychiatric conditions.[3] Therefore, finding ways to maintain social connection, despite not being physically together, has become crucial for good mental health and well-being.[4] 

We and a group of friends have gathered online once a week to share and discuss videos as a way to maintain social connection during the COVID-19 pandemic. What started as an attempt at maintaining and creating friendships came to inspire us to take a closer look at how these discussions contributed positively to our mental health. Now, this group continues to gather online and share videos that support mental health in the hope of developing resilience-based skills and practices. We believe that others, including health care providers, may also find mental-health benefits by building resilience through social connections and making concerted efforts toward introspection, mindfulness, and intrinsic motivation. 

Weekly group video sessions
Before COVID-19 started, we attended a meditation session that began with watching and then discussing a 10-minute video about Taoism. Although the discussion was positive, we felt that more time could have been spent discussing the video. We proposed to a few friends that we watch and discuss the video together (online, due to COVID-19 restrictions). Our transatlantic group consisted of two medical students, one computer programmer, one graduate student in pharmacology, and one postdoctoral fellow in atmospheric science. Our group also represented three cultures: Taiwanese, Lebanese, and Canadian. We watched the video over the course of five sessions, each lasting 1 hour, to give us more time to discuss the lessons learned and how we could potentially implement them in our daily lives. Everybody enjoyed the experience, benefited in terms of mental health, and wanted to continue on a weekly basis.  

We decided on an informal protocol for our weekly group video sessions, though we have made slight adjustments depending on the group’s needs: 

• One group member chooses a video that could support mental health to share with the rest of the group and facilitates the group discussion.
• The group meets weekly for approximately 1 hour to watch and discuss the video.
• Each group member commits to contemplating the concepts from the video and applying them over the following week.
• Group members are discouraged from watching the video beforehand so as to elicit authentic reactions and avoid preforming opinions on the subject matter.  
• Group members commit to an open and trusting environment with no judgement so that people feel encouraged to share their thoughts.
• Once the video and discussions are completed (whether over one or multiple sessions), another group member selects the next video for discussion.  

Three themes: Introspection, mindfulness, and intrinsic motivation 
So far, three broad themes have emerged from our video sharing and discussions: introspection, mindfulness, and intrinsic motivation. 

Introspection
Our first video was an introduction to Taoism, which taught the power of looking into oneself. We learned that while society largely lives in a culture that is geared outwardly toward doing, producing, and succeeding, the philosophy of Taoism suggests that we introspect and cultivate our internal experience to maintain a healthy balance. Practices like meditation, yoga, and mindfulness can help us slow down to reflect, simply let things be, and not forcibly do things. As one of our group members commented, the goal is “well-being,” not “well-doing.”

Mindfulness
This lesson segued well into our second video, which was about the power of conscious thinking and making a conscious effort to choose where we focus our attention. All too often, as we delve into our busy routines, we can fall into the trap of a default mode where we are unmindful and miss what is truly important to us in life on a larger scale. The main lessons we learned were, first, to be aware of this default and unmindful mode and, second, to start making a conscious effort toward mindfulness. There is evidence to support the potential benefits of mindfulness practices, particularly in times of crisis, such as during the COVID-19 pandemic.[5]

Intrinsic motivation
Our third video centred around the 2500-year-old tradition of Buddhism and contemplating what it means to be truly happy. While one may believe that achieving a certain materialistic threshold will bring them happiness, Buddhism suggests that true happiness comes from within. A parallel can be drawn between the Buddhist approach and the concept of intrinsic motivation in modern psychology, where behaviors are driven by satisfying internal rather than external rewards. Without inner happiness, Buddhism suggests that one may be in a constant state of dissatisfaction and, therefore, seek external stimuli to make oneself happy. Such a pursuit may be endless, with pleasant but impermanent stimuli. In contrast, we can choose to cultivate a lasting state of inner happiness, and this pursuit of genuine and eudaemonic well-being is what Buddhists call liberation. Similarly, modern psychology research has shown that intrinsic aspirations are associated with higher well-being and less stress.[6]

Reflections on and applications of the themes
These discussions provided us the opportunity to reflect on our belief systems and thought processes by sharing experiences with each other and gaining different perspectives. The Taoist approach to introspection, the power of mindfulness, and the Buddhist’s definition to true happiness inspired us to reassess how we care for our mental health. Since the inception of our online gathering, many of us have formed new habits to cultivate resilience, including: meditating, keeping a gratitude journal, cutting down on social media, and making a conscious effort to recognize when we are in the unmindful or default state. The pandemic has changed how the world operates, and for us, it has changed how we view ourselves, others, and the challenges we face. The discussions have also given us the opportunity to better understand each other. We have developed close social bonds and felt a sense of connectedness during a time where connectedness is harder to come by. The open and trusting environment in our meetings has made us feel comfortable discussing certain abstract concepts that may be polarizing. Finally, the interprofessional and intercultural nature of our group gatherings allowed members to bring insights from their different backgrounds. It was a chance for many of us to learn about topics that we otherwise would not have taken the time to learn about. 

As people physically distance due to the COVID-19 pandemic, many are forced to spend more time alone, and feelings of anxiety, depression, and loneliness may be heightened.[3] Studies have shown that social connectedness improves mental health,[7,8] as we have felt through this group experience. A silver lining to this pandemic is that it has presented an opportunity for us to slow down and reconnect with experiences, people, or things that make us feel most like ourselves. Our weekly group video sessions would likely not have happened were it not for the pandemic and, by using online videoconferencing technology, we were able to reflect with our friends worldwide. Of course, the opportunity for self-reflection is not limited to now, and we encourage this healthy mental and social exercise at any time. We hope that sharing our positive experience about these discussions inspires others to adopt similar activities that promote mental health through learning resilience-based skills like introspection, mindfulness, and intrinsic motivation.  
—Matthew Assad Joseph Chedrawe, MSc 
—Jillian C. Lin, MBiotech

References
1.    Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.
2.    Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020;395:912-920.
3.    Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry 2020;7:e21. 
4.    Saeri K, Cruwys T, Barlow F, et al. Social connectedness improves public mental health: Investigating bidirectional relationships in the New Zealand attitudes and values survey. Aust N Z J Psychiatry 2018;52:365-374.
5.    Behan C. The benefits of meditation and mindfulness practices during times of crisis such as COVID-19. Ir J Psychol Med 2020. doi: 10.1017/ipm.2020.38.
6.    Kasser T, Ryan RM. Further examining the American dream: Differential correlates of intrinsic and extrinsic goals. Personality Social Psychol Bull 1996;22:280-287.
7.    Kawachi I, Berkman LF. Social ties and mental health. J Urban Health 2001;78:458-467. 
8.    Perkins JM, Subramanian SV, Christakis NA. Social networks and health: A systematic review of sociocentric network studies in low and middle-income countries. Soc Sci Med 2015;125:60-78.

This blog post has been peer reviewed by the BCMJ Editorial Board. Mr Chedrawe and Ms Lin are first co-authors of this post.