The current condition we are experiencing linked to the global coronavirus pandemic is unique and potentially upsetting for each of us. As an event with a high emotional impact that affects the community in unprecedented ways, it can generate typical stress reactions .
The elements that from a psychological point of view make this situation a potentially very stressful event are many.
The central aspect is that of the potential threat to one’s own and others’ health .
Secondly, from a psychological point of view, we must also consider the weight of the poor predictability associated with the infection. The experts themselves did not know about the virus and the information – especially in the early stages – was fragmented and contradictory. This has increased the sense of bewilderment in the face of an “invisible” and “uncontrollable” enemy.
Thirdly, the methods adopted for the prevention and protection of citizens were essentially based on social distancing and the interruption of normal life activities. This has inevitably produced an increase in fear, also reinforced by telematic exposure to highly stressful images or news.
Finally, the reduction of individual planning and social isolation have made the measures for the protection of one’s health potentially generating opposite experiences. On the one hand safety and control but on the other anger and frustration (“To protect myself I have to put my life on standby”).
Specific cases
When we enter into the specifics of certain categories of subjects (e.g., front-line health workers or infected subjects), intense emotional experiences also include anger , terror and guilt (for having infected others).
In addition, there is another specific group of subjects, the relatives of coronavirus victims , for whom the current situation has entailed a further huge emotional impact associated with a complicated bereavement .
Even in the current phase of recovery of some professional and social activities (the well-known “phase 2”), the experiences of the first phases of the pandemic can persist and find it difficult to reduce. Alongside them, other specific stress reactions begin to appear, such as:
- mental and physical fatigue associated with self and hetero protection procedures
- constant concerns about the economic and personal consequences of the lockdown
- sense of uncertainty associated with the still scarce future planning.
The stressful impact of the virus
In conclusion, for more than one reason, the current pandemic situation is an event with a high emotional impact and potentially stressful for each of us.
In fact, it is no coincidence that most of the mental health awareness and prevention interventions in recent months have been based on messages of normalization of the aforementioned emotional states (fear, anxiety, anger and guilt) and other reactions typical of high-level situations. stress:
- mental intrusiveness with feared images
- avoidance of stimuli related to the source of stress
- on the contrary, compulsive search for news on the coronavirus
- sleep disorders
- persistent negative thoughts
- decreased interest in pleasant activities
- temporary increase in potentially dysfunctional behaviors (increased use of alcohol, smoking, junk food).
Stress and the response phases
From a psychological point of view, the classic phases of response to a stressful event are:
- Shock phase: a sense of strangeness, unreality, space-time disorientation prevail. In fact, in this phase an acute reaction prevails which constitutes a mechanism that allows to maintain a certain detachment from the event and to cushion its initial impact.
- Emotional Impact Phase: A range of emotions such as sadness , guilt , anger , fear and anxiety can be experienced . In addition, somatizations may also develop (eg, gastrointestinal disorders and headaches) and there may be some difficulty in recovering calm.
- Facing phase: the subject tries to reorganize himself and we begin to question what happened, looking for explanations.
These reactions coincide in fact with the response phases identified by Solomon (1988) within the so-called “Dynamics of Fear”.
According to Roger Solomon, the subject in front of a potentially traumatic event reacts with a first acute response (phase of becoming aware of vulnerability). Then with a response phase (action phase) in which the individual shifts attention from the vulnerability on himself to the source of external danger. Finally, with a survival phase (control phase) in which the person puts his own resources into play to deal with the problem.
Chronic stress
The dynamics just described illustrate the typical reaction of the individual in the face of a single stressful event of limited duration (point). In this case, in fact, we speak of ‘acute stress’. On the other hand, when the source of stress (or stressor ) persists over time, we speak of ‘ chronic stress ‘.
We must unfortunately note that the current coronavirus pandemic situation is far from point and single. We are living with it and have been exposed to it for months now. The emergency is still continuing , partly in epidemic form, partly through its aftermath. These are slowly emerging and concern health, social relationships, the economic situation of billions of human beings throughout the planet.
We are still far from being able to hypothesize and consider a complete demobilization from the emergency: we are still immersed in the emergency. As a result, we are still a long way from being able to think of ourselves as safe and secure again.
The general adaptation syndrome
The current conditions we are experiencing could better be analyzed by referring to the model Hans Selye (1974) defined it as “General Adaptation Syndrome”, this is relative to the response that the body puts in place when subjected to prolonged effects of one or more stressors . Also in this case three response phases are outlined:
– Alarm , the organism responds to stress by putting in place acute reaction mechanisms both physically and mentally.
– Resistance , the subject tries to fight and counter the negative effects of prolonged fatigue.
– Exhaustion . Since the previous phases cannot last long, if the stressor continues to be present in an intense way, the resources available to the organism, being limited, eventually run out.
Selye’s model, developed starting from observations made on the animal kingdom, helps us to understand how – in the face of prolonged or chronic stress – it becomes even more necessary for us human beings to find useful strategies to reduce physiological activation. and face the effects of the event with our resources.
How to cope with stress: resilience and hardiness
By resilience we mean “the positive ability that people have to manage stress . A dynamic process where people show positive behavioral adaptation when faced with significant adversity or trauma (Luthar, Cicchetti and Becker, 2000).
The resilience refers to the flexibility and deployment of resources to be able to react to adverse circumstances with mental and emotional strength. In fact, resilience allows – alongside transient and physiological negative emotional reactions – to continue to experience positive emotions and a general sense of well-being (Davidson, 2000).
In the current state of coronavirus emergency we are living in a unique condition and we know that things will not go back to the way they used to, at least not any time soon. As a result, all of us today need to be flexible to adapt to rapidly changing circumstances, tolerating some degree of uncertainty.
In addition to flexibility, another important element related to resilience is the sense of coherence . The sense of coherence is a life orientation that has to do with the ability to understand a stressful situation and use available resources to move in a direction of health promotion and a sense of safety. In this sense, resilience is promoted when a stressful event is experienced as understandable, manageable, and significant (Antonovsky, 1987).
Ingredients of resilience
Understanding the event involves understanding what happened , how and why. This helps the subject to increase his sense of control. Coherence also brings with it the manageability of the event in terms of constructive strategies that can help us cope with it.
It will be precisely understanding an event and the feeling of being able to manage it that will allow the subject to find the positive meaning that the impact of the event can have in their life. The sense of coherence therefore forms the basis of resilience. “If I understand what is happening I can face it, if I can face it I can strengthen the idea of myself as a person capable of managing difficulties and finding a positive sense of what happened”.
If we apply what has been said to the current health emergency situation, the necessary conditions to overcome the pandemic in a resilient way are knowing how to adapt flexibly to restrictions or limitations, understanding what happened and how it happened (even if we will never know why. it happened!) to understand the implications of the event on our health and well-being, and be able to deal with it.
Finally we must be able to find a positive aspect in the real problem that gives an important meaning to ourselves (“Thanks to this situation I have learned a little more to focus on the positive things in life!”)
Resilience and endurance
The concept of resilience is closely related to the construct of Resistance ( Hardiness ; Maddi, 2013). The three fundamental elements of Hardiness are:
- Commitment: “I am worth enough to be able to commit myself to facing adversity. I have to commit myself because there are important things in my life “
- Control: “I have the ability to influence the outcome of the problematic situation, both in a negative and positive sense”
- Challenge: “I can learn from this event. Facing this situation is an opportunity for growth and learning “
In an attempt to translate these concepts into operational advice to cope with the stress of the current situation, authoritative scholars in the field of emergency such as Roger Solomon focus heavily on coping with the event through the possibility of creating healthy routines, that is, managing the everyday life by creating new self-care habits or by strengthening existing ones.
Healthy routines
Examples of healthy routines are: getting up at the same time all the time, taking care of your diet, putting on make-up and combing your hair (even if we can’t go out), exercising, sleeping and resting regularly.
To cope with stress, given that restrictive measures and social isolation have also led to a partial reorganization of everyday life, the time “freed” from the commitments eliminated can be enriched by new experiences that can also be implemented in the domestic space and in compliance with the rules:
- Cultivating social relationships at a distance
- Experiment with new hobbies
- Keep a diary
- Engage in domestic chores that have been postponed until now due to “lack of time”
- Study or read
- Go and visit a museum or a place never seen before in virtual mode
- To actively seek moments of deep relaxation (breathing exercises, meditation, autogenic training).
Helping people to enrich their daily lives with healthy routines is intended not only to increase self-care in a broad sense but also to experience control and manageability even in an adverse situation. From this perspective, even a small gesture becomes a positive control experience. Engaging in doing something positive is in itself an example of a choice of action against the feeling of total helplessness and ineffectiveness.
“I can’t change events but exercise control over how I react. We are vulnerable but not helpless!
The most functional attitude to resilience
The attitude to be promoted is that of ” one day at a time ” in which positive experiences can be planned in the short term, with a careful and aware focus on what we feel here and now.
It is precisely in this perspective that all the stress reduction actions that we have listed are placed . Man also – let’s remember! – he is first of all a social animal that is going through this great emergency immersed in an involved community.
From this perspective, another powerful antidote to the sense of vulnerability is social engagement (Porges, 2017) which translates into the search for listening and sharing with people we trust. In fact, man is biologically programmed to seek social comfort when he is under stress, the connection already has an intrinsic emotional regulation effect in itself.
Conclusions
In conclusion, the current situation of the health emergency from the pandemic spread of the coronavirus, has all the characteristics to be able to be defined as a situation of potential chronic stress .
At this moment, still immersed in the risk of contagion and involved at 360 ° in the distortion of our lives, it is very likely that psychological reactions from stress prevail, on several levels.
If, while using our coping resources and our resilient abilities, the symptoms persist beyond the period of return to normal or assume an entity that compromises the functioning of the individual, it will be necessary to seek the help of a specialist who can evaluate the possible establishment of an adjustment disorder or a post-traumatic stress disorder .
