Coping in the Age of Coronavirus

Thank you to our GUEST BLOGGER, Dr. Melissa Briggs-Phillips for taking the time to share her thoughts on how we can all cope as we journey through the changes brought upon by COVID-19. You can learn more about Dr. M on her website.

Thinking about anxiety and depression and WHAT it looks like to move through either or both experiences is pretty much a daily piece of my professional life.

As a psychologist, I have the honor of partnering with clients on their doggedly determined (sometimes exhausting) slog of a journey through, around, and beyond experiences of anxiety, panic disorder, grief and depression. As a therapist that works with executives, I see how these experiences manifest in businesses. Now, in unprecedented ways.

So it probably comes as no surprise that I am (along with fellow mental health providers) …busy. The almost universal, swift and total upheaval of “normal” has already driven the start of a mental health crisis. I read somewhere that hotlines for people experiencing a mental health crisis have had a 500% increase in usage. In addition to new clients, I have had folks from five years ago reach out with “hey, remember me?! I need you ASAP!”

One of my “specialty” areas I love to teach about is mental toughness. I share an approach I call G.R.I.T. Training for businesses and professional development conferences. Well…those all got canceled!

Instead, I’ve been giving webinars about this new world in which we are all living. So! In that spirit, I thought I would write out my thoughts for use as a reference, road map, or menu. I will share how I understand the problem, offer some “reframes,” and be very direct with action items for YOUR deployment.

In this video, Dr. M and Willory Director of Marketing Bridgette Klein talk about the issues below and more.

FEAR

Fear is a useful emotion. I want you to think about fear in two ways: imminent fear and distal fear. Imminent fear might be, “I do not want to get hit by that car, so I will obey that traffic signal.” The genuine and immediate threat of being crushed by a bus leads to an immediate and specific behavior (adhering to traffic laws).

Distal fear might be, “I do not want to live in a box under a bridge in my retirement, so I will save now.” Another distal fear maybe not being able to keep up with grandchildren or work demands as one ages. So the behavior may be eating healthy and exercising.

Guess which one is a more impactful driver of behavior?

You got it. Imminent fear. We have a biological mechanism in place that makes it an efficient brain process. But guess what? It is SUPPOSED TO BE a short circuit, a short cycle. The chemicals and processes used to begin to HURT us if they are used too much, too often.

Imminent fear for health and safety because of COVID drove the most sudden, complete, and thorough personal and social behavior change I have ever witnessed. I am in the BUSINESS of behavior change, and I have to tell you…it is hard, HARD, HARD to get people to change their behaviors.

So the foundational problem here, is that the immediate fear was useful (got us to change our behavior), but that NEEDS TO BE FINISHED NOW. The media are having a heyday with this, using the cognitive distortion tactics that win the ratings game for them, so you are going to have to DO THIS FOR YOURSELF.

Sorry.

Let us focus on the cognitive distortions (that are genuine “thinking errors”) that are the tools of the trade? The psychological weaponry of cable television “news” outlets. I am selecting this because data is suggesting a massive spike in the consumption of cable television news as the place people are getting information about the pandemic.  My clients who are struggling are admitting to obsessively watching it. I will share what the cognitive distortion might look like generally, and how it is being used right now during this pandemic.

All or Nothing Thinking

This is also known as black or white thinking, or polarization. People are either all good or all bad. There is extreme rigidity in using this approach to situations and relationships. There is no room for nuance in this cognitive distortion. No middle. One of my maxims is “magic happens in the middle.” My offices are ALL decorated in shades of gray as a metaphor (not kidding) for this.

COVID-19 cognitive distortion: People are either not getting this because they listened to their governors’ orders or THEY DIE A HORRIBLE DEATH. There is no comprehensive coverage of someone getting slightly sick, staying home for a bit, then returning to work (remotely). Why? Because people would change the channel. Who wants to hear about something so mundane? The numbers, the data, the FACTS are that most people are going to be fine. This is mentioned of course, but not COVERED with dramatic music intros, slide shows of graphic images.

Catastrophizing

I bundle this little gem of a cognitive distortion with two other ones called “jumping to conclusions” and “personalization” and call it MOVIE MAKING. I use this one all the time.

For example, have you ever been waiting for someone and they are late. When you call them, they don’t answer their phone. Thirty minutes later, when they walk in you yell at them, “where have you been?!?!” Your heart rate is elevated, your pulse is quick, you were dizzy with anticipatory grief that they were dead in a ditch on the side of the road, when in fact they ran back to the store to pick up milk and their phone battery died. A full-on limbic system HIJACK based on a FICTION you created in your head. A REAL physical experience – based on a story you told yourself. Making movies about apocalyptic outcomes based on fear, not data, is classic anxiety.

COVID-19 cognitive distortion: Everyone that gets this is going to die alone in a hospital hallway. The only stories are the horrible stories. The majority of the coverage is of disastrous shortages of ventilators and nurses rewashing masks. The pictures of people lost (very real) are not shown alongside the very many people who are back to work (from home of course). One could argue that the media is trying to draw attention to the places and spaces where there is a need, and unrelenting coverage will push for action. I can get that. But if you do not own a ventilator company, or govern a state that could share some? STOP WATCHING.

The presentations of traumatic parts of the pandemic lead to the inability to calculate POSSIBILITY vs. PLAUSIBILITY accurately.

Overgeneralization

This refers to when people draw conclusions about BIG things from limited experience. So, if someone fails a test, they will conclude, “I suck at all tests.” If someone has a relationship end painfully, they decide, “all men suck!”

COVID-19 cognitive distortion: The upper right-hand side of the screen with an ever-present countdown of coronavirus diagnosis and deaths. Sigh. It weighs heavy on my heart; please know this. It is BIG for those of us who are in the helping profession. We tend to be feelers, and when I see that number rise, I can get teary.

This cognitive distortion is screwing up the capacity to measure ACTUAL RISK=LEVEL Of FEAR. The ever-presence of that countdown is creating distress in ways that are not proportional. This is not to say that we were not in danger! I believe the scientists. “The curve” was compelling. I live in Ohio and DeWine and Dr. Amy Acton took action. I never thought I would say I was thankful to live in Ohio (especially in early Spring when the mercurial weather gets to me). They took actions that kept everyone from getting sick all at once. It was a necessary evil. Ohio’s stats are bearing the wisdom of this out.

ACTION ITEMS:

Limit your information to one or two primary sources like the CDC or a major health care system or university website. Check this news source TWO TIMES A DAY, for no more than 30 minutes.

Cable television news uses adjectives, tells people WHAT to think (more powerfully what to FEEL), uses a LOT of feeling words, and exploits cognitive distortions.

If you are interested in some “thought pieces,” try Medium’s coronavirus platform which offers a mix of political, scientific and philosophical vantage points.

Consider “social media distancing.” The data does not lie: overconsumption of social media is BAD FOR YOUR MENTAL HEALTH. So stop. It is not a place to get “news.” When a platform has a job called social media influencer, one should proceed thoughtfully.

Influenced?

News is not supposed to influence; it is supposed to inform. Social media itself can be a beautiful connector, but sadly, that is not how many people use it, in what they share or how they consume it.

If you can relate to any of the cognitive distortions on a more personal level, maybe building a relationship with a trusted therapist is in your future. We do telehealth! You can use your insurance a lot of the time! Consider it. We are safe places to work on cognitive restructuring. It changes lives! I see it every day in quiet, small ways, to large, enterprise-wide ways.

OTHER PSYCHOLOGICAL EXPERIENCES OF THE PANDEMIC

I can articulate some shared experiences that people are having. And for the first time in my professional life, I am ALSO having them-concurrently. It is a new thing for people like me. We tend NOT to treat issues that are close to home” transference” and “projection” being the primary risks making it difficult to remain objective or unbiased. Now, this is unavoidable. My teens are at home for school too. My 14-year-old is experiencing genuine health anxiety for the first time in her life. My spouse is working from home too. As a classic extrovert, I am depleted by video communication with no “energy back,” too.

But my gratitude list is real. Gratitude is NOT THE SOLUTION. It is the interrupter of the pity party, the pause button for the cognitive hamster wheel of negativity.

I have figured out that I cannot “see” as many clients per week via video sessions as I can in person. I tried. I was fried. I made changes. I am writing and trying to decide how to offer webinars in a way that is meaningful to me and useful for others.

Below are descriptions of the psychological landscape I hear about, and some thoughts on navigating them.

BOUNDARY VIOLATIONS

I am a big believer in the power of boundaries. Psychological, emotional, physical. Good lives are the result of great boundaries.

Weeks ago I would have given a client directives about having their work laptop in their bedroom (remove it!), working at the kitchen table (find another designated surface at least!), when and how to start work and end work, when to check emails, take work calls.

All of it is entirely irrelevant now!

Many folks relate to how weird and “off” they are feeling, and what it is, is INSTINCT that boundaries are being violated.

Solution: Accept it is not your fault and not your forever. Look for small ways to represent boundaries. People talk about routines, but I think maintaining them is for a reason they may not grasp: they symbolize BOUNDARIES. When one task or role ends, and another one begins. If you get up, eat something, shower and get dressed in SOMETHING other than pajamas, it represents “okay, I am going to work now.”

Trust me. People who are doing this are reporting better mental health than those who are not. It is JUST a set of behaviors to represent a boundary between rest/home and work.

If you have space, you can carve out for “work,” do it. If not, look for other ways to establish boundaries.

If you can have a schedule of starting and then ENDING the workday, do it. Sign off of work emails at a certain time and stick to it.

If you are a CEO, business owner, president, etc.—you are working like crazy right now and sorry to say, this may be your new normal while you pivot. It will end! But I hear your stories. Small bite-sized chunks of self-care are EXTREMELY important! In reality, you are probably working harder, in spurts, than you have in a long time.

METRICS

A long time ago, my oldest dearest friend listened to me opine about “being overwhelmed” or something to that effect. She calmly, lovingly said to me, “be open to the radical notion that YOU HAVE THE POWER to reject the brainwashing that ‘busy-ness’ is the metric you should use to evaluate your worth and value as a human.”

That one landed between the ole eyeballs.

Can you relate? We trade “I am so stressed!,” “I am so busy!,” and “I am SO TIRED!” like chips in the poker game of modern-day conversation (at least in suburbia). Our lives have just been slammed with a HUGE emergency brake. No sports schedules for kids. No work travel. Totally and completely irrelevant sales projections.

Recalibrate the metrics. That is how. Shorten the field of vision. Do the next right thing (which I JUST learned is a song in Frozen II, and I was delighted to hear it), make the to-do list less ambitious. Check-in with yourself every 24 hours. Have some basic categories of things to get checked off the list.

CONTROL

Okay. So we cannot control a virus. We cannot control our social lives or travel plans. If you are home with young children and trying to be a TEACHER and STILL WORK, you are constantly being interrupted and have pretty much low control over the behavior of your toddler. You are allowing screen time in ways you would NEVER have imagined loosening control over. You are bribing with M&Ms. You are eyeing the white wine WAY too early in the day.

Believe it or not, we spend a LOT of time lying to ourselves about how much control we have.

I think one of the reasons anxiety is spiking is that people have SLOWED DOWN and noticed what is going on in their bodies. They notice weird sensations and odd feelings. Our lives are generally so harried that I think we have MISSED tuning in and are now forced to deal with feeling stuff. I tend to think this might be a gift over time.

GRIEF

You know the list: canceled trips, graduation parties, and weddings.  

No happy hours, concerts, trips to Italy, plans to ask for a promotion. Lost jobs, businesses, homes, retirement savings.

The collective, oppressive experience of GRIEF is soul-crushing.

And it came out of nowhere?! No prep time. It is a traumatic loss experience, and anticipatory grief ALL at the same time.

I think I cry once a day with someone right now, around this very experience.

I want to make grief into two categories to help us think about coping: bereavement loss and transient loss. There is bereavement grief, which is about an irrevocable loss. A loss because of the death of someone we loved.

What we can do is turn a transient loss INTO an irrevocable loss. The sadness we feel is a reflection of how important that “thing” was to us (marriage, lifestyle, job, etc.). But it can be an essential headspace shift to think about these things as TRANSIENT losses, not permanent. When we get overly attached to things as markers of identity (see above) we are vulnerable to being stuck in our grief.

Grief has stages we have all heard about at this point. We have the right to move through these in our ways, at our own pace—denial, anger, bargaining, acceptance and ultimately meaning-making.

ACTION ITEMS

In conclusion, the cognitive distortions we are vulnerable to are being EXPLOITED by cable tv news. Take your power back! In the spirit of “to go” restaurant ordering, here are some Cognitive Restructuring Strategies To Go:

• Distancing: Cognitive and Temporal
  For cognitive distancing, I want you to refer to yourself in the THIRD PERSON and give that person advice. So for me, “Melissa, what you need to do now is finish your thoughts and close your laptop.” Research has shown as CHEESY as it sounds, if you have a problem you are contemplating, referring to yourself in the third person and offering advice can work.
  Temporal distancing is about IMAGINING what the figure might look like to give you comfort. I imagine my kids’ GRANDCHILDREN. You know how your depression-era grandparents saved foil and can make food from sand and water? OUR kids’ grandchildren will say, “Oh yeah, don’t mind grandma; she learned to play the mountain dulcimer during the pandemic.” That makes me smile and give me some comfort.

• Opposite Day
  Season 5, Episode 21 for “Seinfeld” fans. George, a tragic and flawed character, decided to do the OPPOSITE of his instinct and transforms his life. Whatever your automatic anxious response is, challenge yourself to consider the opposite action. It can shed light on some false conclusions you are drawing.
• Op-Ed Vs. Investigative Journalism
  Challenge yourself to STATE THE PROBLEM in facts, no opinions, no feelings words, no editorializing. People Op-Ed themselves all the time. It is often inaccurate and life-limiting. Ask yourself
  1. Is this thought based on emotions or facts?
  2. What evidence here is accurate? What is inaccurate?
  3. Can I test this belief?
  4. Is there an alternative interpretation?
  5. What might the middle look like here?
  6. What am I getting out of believing this?
  7. What does it cost me to believe this?
  8. What impact is this having on others?
• Do something creative
  I do not care what it is. My current favorite is making little animals out of polymer clay and then giving them to people. I have made people cry laugh, and it is the best drug ever to make that happen. Find your thing if that is in you somewhere.
• LIMIT “NEWS” CONSUMPTION! (see above.)

In another 30 days, there will be another set of shared experienced, I am sure. Until then, I wish for health and safety for you all.