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CV-19 is an unprecedented event that is understandably generating anxiety for many. As a therapist working through this period, I feel it is important to separate out rational vs. irrational fear/stress and share some techniques/advice to help weather the coming weeks and months of upheaval.

Ordinarily when people talk about stress and anxiety, therapists/counsellors can point to it being an error in thinking, something that feels catastrophic and although not ideal, is not life threatening. When people feel that they have too much work on and are stressed, there is normally no life threatening concern, though they feel it physically due the body's hard wiring to produce adrenaline and cortisol as if there were a real external threat. Clearly with CV-19 there are both risks to health as well as financial and broader well-being, so how best to deal with anxiety in this situation?

Freud focuses on the difference between "misery" and "ordinary unhappiness" and the important role therapy can play in moving a patient from the first state to the secondary. "Ordinary unhappiness" can include a host of emotions and concerns including worries, sadness and others. It is both unhelpful and perhaps dangerous to not feel these emotions and deny their occurrence. However, getting flooded by anxiety, panicking, taking overly cautious measures, is also not helpful so a balance needs to be struck when dealing with uncertainty.

So how can we best shape our responses in this environment?

Tara Brach, psychotherapist and teacher of meditation outlines a RAIN method to manage emotions:"Recognising our anxiety or all the emotional responses we may have whether that be through the thoughts we have or how we feel things like anxiety in the body; or Accepting that this is how we feel and not beating ourselves up or trying to get rid of these feelings, Investigating the feelings and thoughts in terms of where they are coming from, what other experiences we may have that are contributing, what assumptions and beliefs might be around e.g. telling ourselves this is going to be catastrophic, I am not going to cope; and Nurturing ourselves and others in times where we may be experiencing difficult feelings and acknowledging that in these times where there is real threat around we may struggle".

If we let our anxiety and stress dominate (which is different from acknowledging it in the RAIN method), we then have to adopt strategies to manage it (and these have often been learnt early on in our lives when we developed ways of coping when emotions became too distressing). Some of these strategies may be denial or suppression, i.e. pretend that there is no risk and take no precautions; catastrophising, feeling like this is Armageddon; to fixating on being able to take control of what is happening and make it better for everyone and a whole host of other behavioural responses. The more out of control, powerless and uncertain we feel the more we are likely to do resort to older less helpful coping strategies. Evolutionary psychology shows how uncertainty and feeling out of control can increase anxiety, stress and overwhelm us with adrenaline and cortisol. This can adversely affect our thinking, our health and subdue our immunity system at a time when we need it at its strongest.

To counter this and reduce our flight, fright and freeze response we need to acknowledge our emotional responses and focus on what we can do to feel more in control, create more certainty regards our actions and reach out beyond ourselves to family, friends and community. This in turn can put us back in the driving seat, not in a superhero way, but in a pro-active way. It is no surprise that the politicians are seeking to draw on the war time spirit to illustrate how we have overcome great adversity in the past.

Anxiety, like Covid-19 is contagious and it is hard when others are in the grip of it to not be pulled into the maelstrom of their worst fears. Also, for many of us when we get stressed, we will unconsciously pull on previous times and experiences that proved hard and difficult. Recently, Healthyminds@work (for which I am co-founder) provided individual supervision sessions for a school that were facing highly uncertain times. I was struck by how many of the individuals, when talking about how they were feeling, brought up other losses in their life whether to do with loved ones, illness or other difficult circumstances. When we feel anxious, we need to acknowledge that we are not just responding to the situation in hand, we are also unconsciously processing earlier times and that is why it can feel even more overwhelming.

To mentally help combat CV-19, we need to be able to discuss and consider what feelings are based on fact and what on less rationale but highly understandable fears. This can help us separate our past from the present and help inform how best to act and to hold care and compassion for ourselves and others. In this way we can focus on what we can do to influence the situation, and hold on to our capacity to cope.

Leanne Hoffman

Psychotherapist, Coach, Trainer and Co Founder at Healthyminds@work

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