This past nine months, as we’ve confronted the ongoing COVID19 pandemic, have presented the world with an extraordinary array of challenges. Of course, the primary challenges have been medical and economic. Nevertheless, the emotional and psychological stresses induced by and flowing from the pandemic and its consequences have been extremely significant and wide ranging as well. I’ve discussed how to conceptualize these stresses elsewhere. I would like to consider some of the psychological lessons we might learn from having faced the pandemic.
Being alone
When I was a psychiatry resident back in the early 1980’s the SonyWalkman (the first portable/pocket sized music player) was becoming popular. I had a supervisor, an older and austere German-born psychoanalyst, who commented that this development would be psychologically detrimental-since people would no longer have to spend time with their own thoughts and fantasies-they would be always able to have an external sensory stimulus to distract them. She could not have known how prescient this comment turned out to be. As our smart phones and their multiple modes of communication with others have become ubiquitous appendages for so many, it often seems as if people (and especially young people) are incapable of spending time alone with their thoughts and feelings and unstimulated by constant external input.
Many of us have spent lots of time online and on social media and meeting platforms and have experienced the sense of being constantly distracted. As the pandemic has worn on, some have come to recognize the curative value of a walk in a park or in the woods or some time simply spent quietly in a room daydreaming or reading. When you think of it (if you are not distracted by twitter currently) every “mindfulness” practice and most of what we call “insight-oriented psychotherapies” are trying to get us to pay attention to our inner state (our thoughts and feelings) without distraction-trying to get us to be able to tolerate being alone with an inward focus.
Being together
While lots of time inside and for many of us in close quarters with others may have led us to find value in our chances and capacity to be alone, the past months of “social distancing” have more keenly made us aware of the intense need most of us have for connections to others. At the extreme, we’ve witnessed heartbreaking experiences or images of COVID patients lying in hospital beds isolated from family and even from hospital staff, or elderly nursing home occupants isolated from family and friends. Words like “quarantine”-that before COVID seemed like quaint historical artifacts-have become part of our everyday lexicon. We have never in recent memory had to face the impact of not being able to move around and congregate as we’ve wished-the need to severely limit our interactions to keep ourselves and those around us safe. While we have often felt socially starved, many of us have found that virtual connections-while imperfect-are pretty helpful. We’ve been challenged to adjust, adapt and compromise. Some have refused; but most have been sensible and respectful of the health and safety of those around them.
Unfortunately, as the need to stay isolated has persisted because of insufficiently robust efforts to contain COVID, it has become harder for many to retain the discipline needed to remain safe. While economic stresses have, to a large extent, influenced the reopening of stores, restaurants, and schools, it seems clear that the hunger for social interactions has also been a major influence on these pressures. Watching a movie or a show, eating a meal or listening to music are manifestly different experiences when experienced with others around us. So many of our religious and cultural rituals take place in groups. While the Black Lives Matters protests were driven by anguish over multiple tragic killings, the large demonstrations had a profound emotional impact because of the diversity and magnitude of the groups marching together and speaking cohesively-in “one voice”. So COVID has hopefully highlighted for us the deep human importance and power of connections to others.
Adaptability and resilience
I’ve argued previously that the COVID pandemic has been extremely stressful and that stress has surely been compounded by the mounting loss of life, lack of sufficient progress and widening economic impact; but that it is important to distinguish between stress and mental illness. Stress can look a lot like diagnosable anxiety and depression just as exercising (a physical stress that can raise body temperature, pulse rate and blood pressure) can look a lot like illness-but is not. While many of us have found our sleep, appetite, concentration and at times our mood impacted, we have also come to recognize and appreciate our capacities to face challenges. In fact in a survey during the early days of the pandemic, college students reported higher rates of resilience as compared to the previous year. Too much stress can surely be destructive and harmful, but like exercise, emotional stress and challenges can also help us to build our emotional capacity. Of course, for those who have been ill, or had loved ones who were ill or have died or who have lost jobs, or for those with vulnerability to mental health problems or substance misuse, the stress could be overwhelming. Nevertheless, COVID has challenged us to be creative and flexible in connecting to others, doing our work, solving problems, and nourishing and soothing ourselves. It may have also sensitized us to others who have been faced with struggle, lack of resources and support and with personal or family conflict.
I was medical director of the student counseling service at NYU when the attacks of 9/11 occurred. They had a serious and direct impact on the campus and there were discussions about shutting the university for the fall 2001 semester. I recall one of the deans speaking up at that time. She had grown up in war-torn Ireland and commented that people have grown up, lived and gone to school in some pretty challenging settings. She knew what she was talking about. She argued we’d not be doing students a favor by shutting school as long as we could keep everyone safe. The campus adjusted and stayed open. She taught all of us a valuable lesson about perspective in dealing with adversity and adaptability.
In the next post, I’ll discuss what we have learned about mental health care and our mental health system during COVID.
Wishing all a safe and healthy 2021!