COVID-19 and Psychological Stress

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I am completing this blog while “sheltered in place” on Palm Sunday, April 5, 2020, in the midst of the COVID-19 PANDEMIC. When I began the blog yesterday around 2:00 p.m. (MT), news stations (using Johns Hopkins University as their source), were reporting coronavirus numbers as follows:

GLOBALLY:  Total Cases: 1,181,825;  Deaths: 63,902

IN THE UNITED STATES:  Total Cases: 300,915; Deaths: 8,162

As of this morning, less than 24 hours later, those numbers had been updated to read:

GLOBALLY:  Total Cases: 1,221,396; Deaths: 66,485

IN THE UNITED STATES:  Total Cases: 319,205; Deaths: 9,038

A dire freeze frame of ever-changing, exponentially increasing numbers of human suffering.

A couple of days ago, I viewed a live stream webcast from Dr. Bessel van der Kolk, leading trauma expert and author of the New York Times bestselling book, The Body Keeps the Score (2014).  Dr. Van Der Kolk is Professor of Psychiatry at Boston University School of Medicine, and pioneer researcher in the area of post-traumatic stress. The webcast specifically addressed the coronavirus crisis from the psychological toll of absolutely needing to “socially distance” ourselves from others, and “shelter in place.” Dr. Van Der Kolk was quick to point out however, that our “primary” concern is peoples’ physical safety and illness; and, “secondarily,” the economic fallout. Specifically addressing the psychological impact of the crisis, he identified several “Preconditions for Trauma” as follows: lack of predictability, immobility, loss of connection, numbing, loss of sense of time and sequences, loss of safety, and loss of sense of purpose.

It is not my intent to reproduce Dr. Van Der Kolk’s webcast in this blog, except to underscore the psychological (pre-traumatic) impact of COVID-19. Readers might consider brainstorming feasible strategies for each aforementioned “Precondition,” given the limitations of this crisis.

In the following paragraphs, I only wish to offer a few considerations for the current crisis, informed by my recent professional thoughts.

A few weeks prior to the COVID-19 outbreak globally, or at least hearing about it in the news media, I had been reading a new book by Marc Brackett, PhD, entitled Permission to Feel (2019). Reading from portions of the book’s jacket cover, “Marc Brackett, PhD, is the founding director of the Yale Center for Emotional Intelligence and a professor in the Child Study Center at Yale University….He is the lead developer of RULER, an evidence-based, systematic approach to social and emotional learning that has been adopted by more than two thousand pre-K to high schools across the United States and in other countries….Marc consults regularly with corporations like Facebook, Microsoft, and Google on how to integrate emotional intelligence principles into employee training and product design.”

The 5 “emotion skills” identified by the acronym RULER, are as follows:

Recognize Emotions

Understand Emotions

Label Emotions

Express Emotions

Regulate Emotions

Although Brackett cites “subtle and important distinctions” between the words “emotions” and “feelings,” he uses the two words more or less interchangeably, as do most people.

While there is much to glean from Dr. Brackett’s book (perhaps the subject of a future blog?), I use it now to mention two heightened emotions during this pandemic: ANXIETY and FEAR. From the book’s discussion of “Understanding Emotions,” we most certainly understand that ANXIETY involves “uncertainty and unpredictability,” while FEAR involves “threat and danger.”

At a time when it would be easy to ignore, deny, suppress, even numb our feelings through substances and/or behaviors, we can begin to generate our own strategies, and/or borrow from the strategies of other people, using the acronym RULER as a guide. For example, in the section on Regulating Emotions, Dr. Brackett discusses the importance of “co-regulation.”He writes “Originally, co-regulation was a term used to describe the back-and-forth between a caregiver and infant to support a baby’s stress regulation….A caregiver who reliably provides physical and verbal comfort and reassures the infant, teaches that emotional distress is manageable. A caregiver who does not provide such support teaches the infant that he or she may be at the mercy of their emotions. In this way, co-regulation is the precursor to healthy self-regulation” (italics mine).

Our relational need for co-regulation does not end with childhood. It continues throughout the life cycle. “In adult relationships,” writes Brackett, “co-regulation can be intentional, as when we speak soothingly to someone who’s upset, or try to inspire someone into action….We’re all constantly affecting each other’s emotional state.” Psychologist Sue Johnson, PhD similarly writes “In attachment terms, co-regulation is the baseline from which self-regulation emerges.”

While it may sound contradictory to talk about co-regulation during a time of social distancing and sheltering-in-place, I think we must accept the challenge–and limitations–of seeing, hearing, and speaking reassuringly to those we’re sheltering-in-place with, and through social media. The result? A possible mitigation of psychological stress; the kind of self-regulation psychiatrist Dan Siegel calls “feeling felt.”

One final observation. In his landmark book, Religious Thought & the Modern Psychologies (2004), the late Professor of Ethics and Social Sciences at the University of Chicago, Don S. Browning, PhD makes an observation that some people may find helpful at this difficult time. He distinguishes between two kinds of anxiety; one kind of anxiety that arises from everyday stressors, and another kind of anxiety that arises from being humanly finite; the latter being “the anxiety that emerges from realizing we cannot possibly have ultimate control over our lives.” Dr. Browning is addressing the issue of spirituality.

Because the COVID-19 pandemic threatens our very existence, we are necessarily afforded the opportunity to reexamine what’s important in our lives, and what’s not; what the 20th century philosopher and theologian Paul Tillich called matters of “ultimate concern.” Relationship specialist John Gottman similarly writes: “If you find yourself asking, ‘Is that all there is?’….What may be missing is a deeper sense of shared meaning. Marriage isn’t just about raising kids, splitting chores, and making love. It can also have a spiritual dimension that has to do with creating an inner life together.”

The issue of spirituality may well be the ultimate response to the illusion that we have ultimate control over our lives. COVID-19 seems to be making this illusion very clear.

Bill Bray, Colorado Springs, CO

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