Charting uncharted waters for the sake of sanity

JUDITH ANCER

Even before COVID-19, we were warned of an increase in diagnoses of depression and anxiety, and there was much talk of an epidemic of psychological distress among teenagers. It’s no surprise that the media is now full of headlines about the second global pandemic, the mental-health crisis, as we feel the impact of coronavirus and accompanying lockdowns, and economic and social disruption.

Last week, the secretary general of the United Nations, António Guterres, spoke at the launch of a policy brief on mental health and the pandemic. He said, “The COVID-19 virus isn’t only attacking our physical health, it’s increasing psychological suffering: grief at the loss of loved ones, shock at the loss of jobs, isolation and restriction of movement, difficult family dynamics, uncertainty and fear for the future.” It’s also apparent that many people are experiencing a great deal of frustration, boredom, and anger in addition to the omnipresent underlying hum of dread.

So how do we cope in the midst of a global outbreak of a highly infectious and unpredictable illness? How do we keep it all together? We still have to earn a living, manage our kids’ schooling online, and find ways to deal with living on our own or with other people in close quarters.

How do we “keep our heads” when all about us, on WhatsApp groups and Facebook, others appear to be losing theirs because they’ve run out of cigarettes and whiskey, or just “refuse” to exercise wearing a mask.

How do we wade through the excesses of wildly contradictory information, or make do with the paucity of verifiable fact? Maybe up seems down, and our minds want to unravel.

Extended anxiety, frustration, and uncertainty lead to raised levels of stress hormones and consequent disturbances in sleep. There are increases in body aches and pains, nervousness and irritability, and decreases in energy, focus, and motivation, as well as reduced capacity to think rationally and make good decisions.

However, there are simple strategies that can assist many of us to manage our most difficult emotions. The first is to accept that these difficult feelings are a normal and appropriate response to the situation.

What is most helpful psychologically is to identify what you are feeling. Once you have named this for yourself, accept that the feeling is part of you and practise self-compassion in relation to having the feeling. Whether it’s anger or fear, take a slow, deep breath, exhale slowly, and tell yourself that the feeling will pass through you.

Research shows that we can train our minds to be calm and turn away from total negativity. We can learn to tolerate uncertainty, and accept that we have limited power to change our immediate physical circumstances.

Even if the limitations of our power make some of us feel enormously frustrated or panicky, there are strategies that help us gain a sense of calm, even if for short periods of time. These include “mindfulness” activities like meditation, prayer, making and fixing things, as well as being in the moment. Listening to music that is meaningful, reminding ourselves to notice a beautiful tree through the window, the sound of birdsong, savouring a delicious meal, and practising self-compassion is also very helpful.

It’s obvious – but worth repeating – that self-care isn’t an indulgence, but essential. Exercise, movement, dance, singing aloud, gardening, cooking, journaling, watching movies or series, eating in a balanced way, laughing, watching videos of animals on YouTube. These all enhance our physical, psychological, and social well-being.

Fear, anger, and resentment are contagious, so avoid excesses of social media, and don’t baste yourself in information, COVID-19 monitors, and opinions about what’s happening.

If the future seems overwhelming, another important strategy is to shift your focus from the long or even medium term to what needs to be done now, what the next right thing to do is. We can’t do everything, but we can do something. And what we do makes a difference – that may be to message a friend who lives alone, make a cup of tea, or call a counselling service for assistance.

I have been moved by the work of the brilliant psychiatrist and Holocaust survivor, Viktor Frankl, who knew first-hand the nature of loss, helplessness, and suffering. His core idea of the importance of finding meaning in our lives helps me to make sense of how best to cope in challenging times. Frankl explains that all people are driven by a will to meaning as a primary life force, and this meaning is present in all our lives in three ways:

1.    There is meaning in what we create, what we do and make, and in our contributions to the world – what we give to others.

2.    There is meaning in what we experience and take from life, especially uplifting experiences, things like pleasure, memories, relationships, and love, experiences that involve empathy and an openness to needing others and taking from others with grace.

3.    Finally, there is meaning in our attitude to suffering that is unavoidable and out of our control. Of course, we must avoid unnecessary suffering and change what can be changed. But we need to have the wisdom and courage to accept what can’t be changed. If a situation can’t be changed and suffering can’t be avoided, what is retained is the individual’s freedom to chose their attitude to their suffering.

Frankl never says this is easy or simple. It’s a life project to change ourselves and find meaning in what has brought us suffering. But it can be done. He writes, “The moment suffering becomes meaningful it loses its unbearable quality and becomes another one of life’s tasks which offers a special and great challenge and reward.”

It’s my hope that out of the catastrophe that is this pandemic, we are all able to find some ways of coping and making meaning that allow us to bear the unbearable with grace and courage.

• Judith Ancer is a Johannesburg-based clinical psychologist.