Corona Virus / Covid19 – coping with anxiety during a traumatic event

| Lee Sharp | Blog

My name is Lee Sharp of Unmasking Psychology.  Our aim is to Engage, Educate and Empower people and organisations alike in order to lead to better mental health.

As at March 29th 2020 we are just over one week or so after the imposed social distancing for all people (with a few minor exceptions) and the closure of shops, restaurants, theaters, pubs and clubs.  Those most vulnerable have been advised to isolate for 12 weeks – all a result of the corona virus pandemic. Its impact now, if it had not already, becoming an historical reality for the UK and the majority of the world. 

Around the world we are at different stages of our understanding with reports from Italy and Spain being terrifying - we have finally understood what is coming, even as questions remain over whether the UK’s response has been optimal or not.  We will not know the answer to this for some time yet.

My focus today will be on contagion and subsequent anxiety in the context of a global emergency and I will try and UNMASK the Psychology behind the issues that we are facing currently.

In an emergency situation such as this, should we be even be concerned with our psychology or is this a luxury we cannot deal with at present and is completely dispensable.  In any emergency, the resources that are available to you must be assessed and usefulness determined. This is no different.

What makes this such an odd emergency is that the most effective contribution that any of us can make to our own wellbeing and that of others is to stay home.  There are but a few people for whom it is necessary to go about their normal business for the survival of others (medical staff spring easily to mind – but are not the only ones).  Unless your presence is critical and if you can possibly afford to do so, you should stay home. I will not repeat the medical reasons for this here – you’ve heard them all. But this advice is clear.

We are being forced into a type of individual retreat situation.  We have more time on our hands than ever. This means that we are being left alone with our brain and the thoughts that we generate with it.  But you are not alone as such. Social media and 24 hour news brings a constant stream of information and input, together with contact from friends and family that we are concerned about or are concerned for us.  For some, this will be the first time that you have really been left alone with your attention and thoughts. For others, this will be a more extreme situation of something that they face frequently.

The reality in this sense is just setting in and is something that most of us have never experienced.  Because we are dealing with contagion, a biological one, passed on through social contact, the spread of fear and bad ideas is strong.

As a result, the urgency to get ourselves thinking straight is acute, more so because our response and how we conduct ourselves can impact someone else in such a direct manner.  If you do not care for your hygiene properly you are literally putting peoples lives at stake, yours, others you love and care about, and of course others you have never met.

A basic awareness of what we are doing is really the only tool we have at our disposal to try and assist others.  Being aware of exactly what you are doing with your hands is harder than you think. Some of you will recall seeing a US press conference with an American spokeswoman talking about how important it was not to touch your face in public – she then promptly licked her fingers to turn the page on her notes – demonstrating her complete lack of awareness of her own actions.  How can we avoid touching our face if we are unaware of what our hands are doing? We are not always aware of what we are doing even when specifically talking about it – our thoughts are no different. This is a problem.

We could consider trying to train our attention.  To recognise it and understand as far as possible what is happening.  For a beginner, this is what mindfulness or meditation essentially is.  I am not going to sit here and preach that we should all start meditating our way through this or that mindfulness is the answer.  But recognising your thoughts and trying to cope with them is the answer and for some, meditation and mindfulness is a route to achieve this.  For those interested, there are some great meditation and mindfulness books and apps available if you are so inclined.

I wish to discuss more the impact that we can have on ourselves and on one another.  Contagion of the virus is bad enough, but the impact we can have is as powerful. The world is entangled ethically and emotionally at this moment with everything we say and do, and how we say and do it, having an impact on those around us, their mind and the way they think.  It matters what you say and how you go about communicating that. It has always mattered, but more so now than ever.

You need only watch the news for a few minutes to see the way that issues are reported and to know that in some way, shape or form, this influences us and our thoughts.

In the last few weeks, I could feel physical agitation and psychological arousal rising.  It would come and go and I was generally able to manage the thoughts. But this reached a pinnacle just over a week ago when the pub closures were announced.  For a good 20 to 30 minutes that day I was somewhat lost in this psychological agitation and arousal. It took me that long to realise that ultimately it was unnecessary and unhelpful, but worse, it was actually quite toxic for me and those around me.

Recognising such an unhelpful thinking pattern and challenging them is a key component of psychological assistance.  Meditation and mindfulness is just one practice that can assist, but other forms of psychological understanding and therapies such as Cognitive Behavioural Therapy and Acceptance Commitment Therapy also address unhelpful recurring thought patterns in addressing behaviour change.

This awareness is vital.  I noted that as I was talking to my wife on Friday about what was happening, I could not initially hear and detect my underlying anxiousness.  This led to everything I was saying coming from that anxiousness and the message I was trying to convey was also imparting my stresses.

This is as contagious as this virus.  I was of no comfort to my wife in that moment.  I was of no comfort to my children in that moment, at least one of which is old enough to have a reasonable grasp on what is happening.  It took my wife Sami to tell me that I needed to take a moment and calm down – practice what I, as she put, “so often preach”. She correctly put the responsibility on me to order myself, relax, so that I was better company, better use to our children and better for myself.

So using what I know, I did sit and spend time with my thoughts, but properly with them.  Not to let myself be overwhelmed with thoughts, but to allow the thoughts to occur, recognise them, then let them go again.

But how would I have done this without the insight into the nature of anxiety and how mindfulness or other practices can assist in doing so?  How could you do this?

Most of us do this by watching TV, exercising and therefore diverting our thoughts - but this is likely temporary.  It requires effort and training to respond in the moment of stress by letting go of it. This takes skill and training.   No different to riding a bike, using a computer, doing handstand. You can either do it or you cannot. But make no mistake, you can learn to do it.

Mental training is something that we could consider as vital as physical training.  Good physical condition is always considered a good thing in the time of an emergency.  Well I consider good mental conditioning to be as important.

You might look good physically, but how are you going to act and react on the most stressful day or days of your life.  When your loved one gets sick or dies, when you lose your job, when a deadly virus hits? Who are you going to be then?

On that day or in those days, you only have the brain and mind that you have built and the skills you have learned.  Your psychological tool-box will be with you, but will you and do you have the tools for the job – especially if you do not know what the job looks like?

Honestly, it is now clear as day that we are all going to experience in many ways an extraordinary amount of stress over the coming months, almost guaranteeing a common fate across societies and the globe.  The only previous world example of this was probably the world wars.

In many ways, we have been dragged into a war and as with wars, we need to care for those around us and ourselves.  But unlike previous wars, where the majority are doing their bit to contribute (be it soldiers off to fight, those at home feeding everyone or making equipment), the vast majority of us have been told we can help by doing nothing and staying home.  

We now expect this to last for many months, with the only likely change coming through a true breakthrough in effective treatment or vaccines.  Sadly, I have to believe that both of these things are still many months away at least – (as current guidelines and historical evidence would indicate).  We could therefore expect this to continue for sometime and therefore, many of us are likely to find us having time on our hands.

The challenge will be to maintain social distancing and we have seen our politicians around the world sharing their concerns about the impact that social distancing on a long term basis can have mentally.  With isolation also being openly discussed for large swathes of the population, this mental health need increases.

Remember, people being punished for crimes in prison are sometimes put into solitary confinement as an additional punishment for something that they have done.  Solitary confinement is a punishment for those being punished. People prefer company to being alone with their own minds. Indeed, a recent American study showed that people would in fact rather give themselves electric shocks than sit quietly with their thoughts.  Let that sink in for a minute - people would rather give themselves electric shocks than be left with quietly with their thoughts.

But why?  It is because an untrained mind, which by the way is a perfectly normal one, can be an incredibly unhappy place to be.  Our own mind can be an unhappy place to be in, and be terrible company. If it is an unhappy place for you, do you think it is good company for others.   No, it is probably less than ideal for them at the very least.

So what do we do?  Well, if we care about others around us and our own sanity and effective support for others, we could try and pay attention to our own thoughts and our own mental suffering when it occurs.  This involves understanding mental health and the mechanics of how you might be suffering mentally, through anxiety and self concern. The alternative is just to push and make other people aware of your own unhappiness and to push it on others.

So here are just a few of my thoughts on anxiety at this time:

We must acknowledge that anxiety is a hugely useful evolutionary tool on the whole.  We would not wish to banish anxiety entirely from our minds as it is an emotional signal of perceptions and interactions designed specifically to get our attention.

It is no a mystery to most of us why we become afraid - it is a physical and social protection that has protected human beings for thousands of years.  We do not wish to get rid of anxiety or fear. In fact, when treating anxiety, one of the first things I try and get clients to understand is that the goal is not to avoid anxiety – if you do not want to experience anxiety, you will experience anxiety.  What is beneficial to us is letting go of emotions, in this case anxiety, when they are no longer beneficial to us.

Let me explain further.    There is a difference between an acute short lived anxiety to new relevant information that demands your attention VS becoming chronically anxious as a result of this same new relevant information.  These are completely different mindsets and you have a choice which mindset to use. You can choose what you do with your attention.

But to do so, you have to be willing and able to recognise the thoughts that you are having, and the flow of emotions that occur as a consequence, and recognise that the two can be separated.  You do not have to react with the emotion that would often follow the thought.

Learn to pay attention to the two things and reach a calm composure during the difficult time, what psychologists would call equanimity.

So back to the Friday when the big shut down was announced and the pubs closed to prevent the spreading of infection.  I had seen doctors in Italy reporting how bad things were, that they were now watching colleagues fall ill and die, imploring people to stay home – openly grief stricken and overcome with emotion.  The same doctors and our politicians were warning this is coming to a city near me soon. So, knowing this tidal wave is coming, I could feel my anxiety levels rising, having heard about devastation elsewhere and knowing that at present, there is no known method of stopping it or particularly slowing it from reaching the spot where we are located.

What could I do?    How do I separate the beneficial from the useless?

I started by recalling that part of the emotional response is useful.  Compassion, concern and a desire to protect my family and help my fellow humans.  For example, it was exactly this reaction and understanding that with “my apparently trained brain” I was still overwhelmed and no use to anyone, that has drove me to record this webcast and to accelerate the digital aspect of my work to reach and help people.

I have utilised the energy for improvement for me, my work and hopefully as a consequence, the benefit of others.  Afterall, the core purpose of the British Psychological Society is defined in our charter as "the diffusion of knowledge of psychology and ... the usefulness of members".

But most of what I was experiencing on Friday evening was of no use or benefit and was rendering me useless – the opposite of what I desire to be.  I am better without the bonds of the anxiety that hijacked my thoughts and felt like they compelled me to hold the anxious thoughts in front of my face as if it was the only thought my brain was generating in that moment (which of course it was not – it was just the only thought gaining my attention).  Nothing would be helped by imparting an anxious urgency.

Given my experiences with psychology, I was able to notice the machinery in action.  The thought being generated, the emotional feeling that paying attention to that thought left and subsequently the action that was driven in me as a result of the thought and feeling.  By separating the three, THOUGHT, FEELING, ACTION, you can begin to understand that if you try to impart your will when you recognise the thought, you can therefore gain some control over your feelings and action.

If you are unable to pay enough of your attention to simply notice when your thoughts arise, these thoughts are likely to become you.  You will find it difficult to distinguish between the thoughts that arise in your mind and your reactions to them and you will become a slave to your thoughts.

As an example, we have heard that we are two weeks behind Italy and therefore in two weeks our hospitals will be overwhelmed.  It is beneficial to understand the probability of this being accurate, but it is not however worth helplessly ruminating and worrying about this.

The difference is not if thoughts arise or not – they do constantly.  Some will be arising in your head now as you are reading this, you are trying to read but your mind is also speaking to you.   If you cannot recognise this it will feel like this is who you are – feeling identical to the thought that arises.

Many us of believe these thoughts are us – but they are not.  Thoughts come and go – how much attention you give them matters.   How you respond to them is you.

With so much to think about now, health issues, associated stock market problems, long term job implications, political issues, global issues, this anxiety and psychological arousal is needed and necessary to assist us in decision making.  But the overwhelming majority of your emotional responses at this time will be detrimental to your relationships and life in general.

So, if you are currently able to work from home, if your career, business or ability to earn income is relatively unscathed to date, what benefit and use to you is it to experience excruciating anxiety whilst doing the work?  How much use will the terrified feelings be to you during this time? You don’t need a psychologist to answer that one for you.

But now is the time to start to get a grip on how your mind functions and you do want to do what you can to try and get such a grip.  Mindfulness and meditation are routes that some will wish to explore, a deeper understanding of psychology will be the choice of others.  Understanding CBT or ACT will likely benefit many people. I can promise that with effort, you can learn how to separate the thoughts from your reactions.

I once explained how thoughts and reactions do not have to be the same to my son, who a few months later wrote a poem about it for his English class, I am going to share that with you:

The Stream

The Stream is full of sadness, the stream is full of happiness.

The stream is full of disgust, And mainly full of anger.

The steam is what you make it, whether you react or thrive,

The stream is full of flowers, the stream is full of opportunities.

The stream is what you make it, if you pick up these emotions,

while you are by the stream you will see what happens.

Will you take the opportunities the stream brings by?

The door is open my friend.  Will you grab it?

I warn you now the stream is no loop.

The stream is what you make it.

By separating your thoughts from your reactions, you allow yourself time to acknowledge what you are experiencing, to accurately label it, and assess the pros and cons and therefore how you might react to it.

As a psychologist I have often heard my clients say that they do not always have time to spend thinking about thinking, thinking about how and what they think and how they react to what they are thinking.  The greatest contribution you can make to society is to stay home. Now of all times, we have time to understand ourselves. I would urge you to take time and pay attention to the nature of your mind.

How?  Well, do not try to do too much yet.  Allow yourself time each day to acknowledge your changing thoughts.  Recognise especially any recurring thoughts or feelings that bother you and indeed those that make you feel great.  These thoughts are the leaves on the stream – if you pick them off the stream, you are giving them attention. If you let them pass, you noticed them, but are not giving them non-beneficial attention.

If any thoughts seem overwhelming at all, you could write them down.  If you do, write down not just what you thought or felt, but reflect on what happened immediately before (was there an incident, a discussion with someone, did you watch the news or read something online).  This is what we call a mood or thought diary – examples exist online and if interested and you intend to follow this podcast (or my webcasts), you may benefit from starting to keep one yourself over the next week or so.  This will give you insight into how the THOUGHT, FEELING, ACTION works exactly for you.

So that’s it for now, I’ll be back with more soon – specifically addressing more about mental health on the whole, anxiety, depression, substance misuse and other subjects to try and lead us all to better mental health.

Be kind, to yourself especially at this time, and be kind to others.

Back soon.