So we’re a little over a month into the insanity. How is everyone doing? I hope you all are doing as well as possible and staying safe.
For me, personally, it’s been up and down—I’ve already been self-quarantined since my stem cell transplant, so my daily life hasn’t changed that much. However, I separately have been struggling with graft vs. host disease over the last few months. I was improving initially from my transplant but starting taking a turn downward about two months ago.
Thankfully it’s a minor form of GvHD (so not dangerous) but it’s not minor in terms of how it makes me feel. My energy has disappeared along with my appetite, and I’ve lost a lot of weight. I feel nauseous and sick most of the time. And even for my introverted self, the degree of isolation—along with being physically ill—has me a bit depressed.
I think I’ll save the update on how I’m doing personally for a future post. I don’t want anyone to worry in the meantime, though, so just know I’m not doing terribly or anything like that. In case you’re interested, I have more frequent video updates on my personal life (and other topics) in my Life Teachings membership program.
What I want to share with you today is some thoughts on coping skills. We’re a little over a month into this crisis, and we’ve had some time to get a basic idea of how we act when things get tough. We’re in a period of collective anxiety and stress, and inevitably we’re going to have different personalities, tendencies, and skill levels for how to handle it. It’s human nature.
In my field of psychiatry, we talk about “defense mechanisms,” or strategies people use to cope with difficult or uncomfortable emotions. Defense mechanisms are generally split into two categories—”mature” and “immature,” or emotionally healthy and emotionally unhealthy. Basically, is the coping skill adaptive? Does it help the situation, or make it worse? Is it supportive of a person’s psychological functioning and their relationships, or not?
When the Coronavirus pandemic first became a reality in our daily lives, I was uneasy when I saw some of the less healthy defense mechanisms on display.
We’ve all heard of Denial—for example, if a person is diagnosed with cancer and then acts as if it’s not happening (not showing up to doctor’s appointments, changing the topic when a friend or family member brings it up, etc.). Denial is when a person deals with their discomfort or fear by pretending the situation isn’t happening.
I saw this manifest with the Coronavirus; even my physician colleagues weren’t immune. Posts on Facebook insisted “It’s just like the flu guys,” or “Wash your hands and you’ll be fine.” I saw otherwise responsible holistic medical practitioners claiming the virus was a manifestation of our minds and could be cured with green juice and positive thinking.
I saw Rationalization, which is when a person uses an intellectual and seemingly logical explanation to justify something they did that makes them uncomfortable inside—perhaps an action or behavior that is incongruent with their stated values. We all do it sometimes, myself included.
What I saw with Coronavirus was people engaging in, and then explaining away, what was clearly selfish behavior—not following social distancing guidelines because of the inconvenience, or hoarding toilet paper, food, and even worse, medical supplies, without thinking about the shortages they perpetuated.
That guy who hoarded Purell to mark up and sell on Amazon is a perfect example—his explanation for why he did it was not “The money sounded so good that I didn’t want to have to consider the effect on others,” it was “Well, you see the way that capitalism works is…”
I also saw Misattribution, which is when a person feels anxiety from one source but isn’t able to express it back to that source, and so they misfire it toward someone else—for example, if you feel stressed because of something your boss said, come home, and then snap at your child for something small.
The Coronavirus pandemic is a recipe for disaster in this regard, as many of us are simultaneously operating a hair trigger away from losing it, living at the very edge of our bandwidth.
What I’ve seen is people taking their generalized anxiety about the virus and misdirecting it to neighbors and others they come across in their daily lives, being overly harsh with those who may deserve a little bit of frustration… but not as much as is dished out. I understand it to some extent, and I get frustrated myself when people take unnecessary risks that could harm all of us. But the degree of anger I see is sometimes out of proportion to the offense. Instead of blaming the virus, we started blaming each other.
It’s not all bad, though—at the same time I’ve seen heartening displays of healthy coping strategies like Humor, Humility, and Altruism as others sublimated their fears into action. One student sidelined from college started a nonprofit to deliver food and supplies to elderly and immunocompromised people who couldn’t safely shop. Adept seamsters are hand-sewing masks for healthcare providers who don’t have enough. Online, comedians are entertaining us, musicians are singing for us, and DJ’s are throwing dance parties.
Look, we all are human and no one person is defined by one behavior, and none of us is defined by our worst moments. We should forgive ourselves for our mistakes, and we should ESPECIALLY forgive others for theirs. Use what I’m sharing with you not to judge others, but to work on bettering yourself. Instead of going straight to habitual negative coping skills that may not be productive, take a pause and try one of these strategies instead:
1. Undoing: It’s what it sounds like—when you have a negative impulse toward someone, do the opposite action instead. For example, if you’re on the verge of snapping at a neighbor for not following the rules, leave a little gift (a puzzle or coloring book, maybe?) on their doorstep instead. It’s the “kill them with kindness” approach. Of course it’s reasonable and often needed to set limits with others. But even if others aren’t doing the “right thing” and following the rules… what can you do to bring out the best in them? Trust me, we all want to have the best brought out of us.
2. Anticipation: If you feel anxious and uncertain about the future, direct some of that anxiety into purposeful planning. It’s not possible for us to control the world, but we have influence over a small corner of our world. Use whatever control you do have to make contingency plans for the future, review your budget so you have a plan in case you lose your job, meal plan for the upcoming week, etc.
3. Humor: Sometimes humor is an unhealthy defense mechanism, like when a person makes a joke to avoid a difficult conversation, but it can also be healthy and adaptive. We all have to laugh sometimes, even in the most difficult circumstances. If you heard some of the morbid cancer jokes that get thrown around at home with my husband, it might make you cringe… but it helps us find moments of lightness even when things are hard. So be willing to seek out laughter and share it with others—maybe watch a comedy special one night instead of the news?
4. Humility: It’s important to know what you don’t know, or at least be aware of the fact that there are things you don’t know. I see this trait sometimes lacking in fellow physicians, partially because the medical education process often rewards overconfidence over humility, especially among men. It can be uncomfortable to acknowledge when we don’t know something, and indulging in feelings of superiority is a habitual way some of us handle it.
If you open yourself to humility, though, you will find it is a much more rewarding way to exist. You may be surprised by how much more you can know if you are willing to listen to people whom you might have otherwise dismissed. It’s also nearly impossible to change someone else’s thinking unless you’re open to changing your own. So just think: less lecturing of others about Coronavirus, and more listening. If you find yourself open to having your mind changed at unexpected times, then you’re on the right track.
5. Altruism: Altruism is the most wonderful coping skill of them all—to reach the point where you are able to derive happiness and strength through helping others. The best part is we don’t all need to do the same thing; we each can do what we’re best at based on our personal abilities and experiences. Altruism allows individuality. Imagine how much better the world would be if we all found satisfaction from helping others in the way we felt most skilled to do.
The strongest and most mature coping skills are all forms of Sublimation—of taking our difficult emotional experiences and transforming them into something good, both for ourselves and the world. It’s part of why I share my personal experiences with you all here; it gives me purpose to share my story in a way that might help another person. Honestly, it would not be tolerable for me to go through what I’m going through if I could not derive some meaning from it. I don’t believe everything happens for a reason, but I believe we can find meaning in whatever it is that happens.
I’ll end on this note, based on what I can tell you as both a psychiatrist and cancer survivor. Remember that everything ends. All good things end and all bad things do, too. Revel in the fact that your future problems may seem small in comparison to what you’re dealing with now.
I know how shocking it feels—this experience of waking up in a new world and wondering if it’s just some terrible nightmare. I promise you can handle it better than you think. The sooner you acknowledge you can manage whatever comes, the faster you’ll figure out specifically how. The situation does not need to change for you to change how you feel about it.
Now take that fear and anxiety and transform it into something good!