Listen

As with any worry that a human might have, the most helpful thing you can do, especially initially, is listen. Listening patiently will likely be the most impactful for someone who is worried about the effects of the virus. Asking open ended questions without assumptions will help you to understand the specific and individual things that make the person you are talking to worried. For example, asking “What are you most concerned about with regard to the Coronavirus?” will yield important information as to whether the person’s primary concern has to do with their health, the health of a loved one, finances, the public good etc. Understanding and making reflective statements about their concerns at a deep level will help them to feel less alone and more understood. This alone can help calm people down and mitigate anxiety.

Normalize

One of the things that humans dislike more than anything else is uncertainty. Not knowing if we are safe or unsafe is one of the most unsettling feelings a human can experience. Facing a known threat is scary, facing an unknown threat is terrifying. Naming this aspect of human nature, normalizing it and discussing how this is tied to our evolutionary history can be helpful for people who experience anxiety with regard to the virus. The human brain is excellent at turning on the danger alarm (“fight or flight” – sympathetic nervous system response) and not as good at turning it off (“rest and digest” – parasympathetic nervous system response) The act of labeling fear of the virus as a kind of fear that arises from uncertainty is also helpful as it makes the target of our conversation creating as much certainty as possible. Beyond listening, as above, the most helpful content to a conversation about the coronavirus is reducing uncertainty either by focusing on what we control, changing our thoughts, accepting our thoughts or by changing our behaviors.

Focusing on what we control

In sport psychology we use the acronym APE as a way of identifying what is in our control. We can always control our Attitude, our Preparation, and our Effort, and with regard to concern over the Coronavirus, it’s very important to try to focus our attention in these three areas. In a natural effort to reduce anxiety in situations like these, our thoughts often drift towards things outside of our control. We think of what might happen in the future and possible negative outcomes. None of these possible eventualities can be controlled by us as they are in the future and are impacted by many factors outside of our direct impact. When we begin to worry, simply asking ourselves, “Can I control that?” and refocusing on improving our Attitude, Preparation or Effort can help us to optimize our thinking and behaviors during this confusing time. The other acronym that is helpful with regard to controlling what we can control is WIN (What’s Important Now?). By training our brains to refocus on what is important in the moment, or what changes can be made to our thoughts and behaviors in the moment, we capitalize on the things that we do control and divert our attention away from getting stuck in future oriented worry.

Changing our thoughts

As with other health related worries, our thoughts inform our feelings. The ABC paradigm used in Cognitive Behavioral Therapy (CBT) is a simple and clear way to understand the relationship between thoughts and feelings where A stands for Antecedent event, B stands for belief and C stands for emotional consequence. Much of the time there is an A-C connection. In other words, there is a Coronavirus Pandemic and all of a sudden, we notice that we have a strong emotional reaction. We may feel anxious, scared, overwhelmed and uncertain. We can help people understand the difference between thoughts and feelings. People confuse thoughts and feeling by saying things like “I just don’t feel safe”. This isn’t actually a feeling. A feeling is an emotion. The person might feel scared or vulnerable. A feeling can never be debated but a thought can. Simply refocusing on facts that calm us down can be helpful. For example, when you notice you are thinking about some or the scary possible results of the virus, try to refocus on real facts that can calm you down. Thoughts such as “Right now I do not have symptoms” or “Many thousands of people have successfully recovered” can be very helpful in putting things in perspective.

Also helpful is Chronesthesia (mental time travel). Not joking! Imagining ourselves in the future, estimating where we will be, what we will likely be thinking and feeling when the virus passes, can be very helpful. Lastly, gratitude has been shown to help people to be resilient towards all kind of stressors. People sometimes misunderstand the practice of gratitude as meaning that one must ignore what is objectively scary or wrong in their lives. On the contrary, we practice gratitude in spite of what’s wrong to help us put our lives in perspective. By reminding ourselves of what is right, valuable and appreciated in our lives, we can dwarf the shadow that what is wrong casts on us. Spending some time each day during this difficult time journaling about or discussing all the things we appreciate about our lives can be very protective towards Coronavirus stress.

Accepting our thoughts

Sometimes, despite our best efforts to change our unhelpful thoughts, they linger. In these cases, it may be helpful to practice mindful acceptance of our thoughts. Our thoughts aren’t dangerous and sometimes avoiding or resisting our negative thoughts about the virus may in fact compound our anxiety. Mindfulness can be defined as “learning to accept the present moment just as it is”. Taking some time to just focus on breathing for 5-10 minutes a day can be very helpful. Also just saying to ourselves, “just a thought” or “this will pass” when we have a worry or obsessive thought can help in habituating to thoughts that were once bothersome.. We also recommend apps such as Headspace and or Calm.

Changing our behaviors

While feelings are impossible to directly change and our thoughts are also difficult to modify (you can’t change/prevent a thought but you can change your response to a thought), our actions are more directly under our control. Making sound choices around behaviors during this time will be critical in diminishing Coronavirus worry and anxiety.

• Keep or make appointments with mental health professionals. Many people may cancel their appointments for various reasons. Some may cancel because they are “too stressed”, others because the are unfamiliar or weary of using telehealth or video session. While not ideal and sometimes difficult to schedule during this confusing time, its better to keep appointments even if they are inconvenient and even if tele-therapy isn’t perfect.
• Don’t isolate. While we are all socially distancing, we shouldn’t take that practice literally! Making sure we are staying in touch with friends and family is important in reducing a sense of uncertainly and isolation. Working with the help of a trusted friend or therapist to overcome both logistical and emotional problems that may get in the way from reaching out to others is essential in helping to overcome stress and anxiety in this hectic time.
• Moderate the consumption of news. While it’s important to keep abreast of public health advisories, much of the information that is disseminated regarding the virus is sensational, alarmist and unhelpful. It is important to develop a healthy relationship with one or two reputable sources that allow you to stay informed without getting overwhelmed with dramatized and speculative news that can make you unnecessarily anxious.