Late last week, we gave a presentation to about 20 chief medical officers from health care systems around the country. I began by asking them to share a sentence or two about how they were feeling, personally. Over the next half hour, their answers spilled out in a torrent.
“Exhausted, overwhelmed, and anxious.”
“I’m feeling fearful and fatigued.”
“Frustrated and dismayed.”
“The current workload is not sustainable.”
We are dealing with two contagions — the virus itself and the emotions it generates. Negative emotions are every bit as contagious as the virus, and they’re also toxic. Fatigue, fear, and panic undermine our ability to think clearly and creatively, manage our relationships effectively, focus attention on the right priorities, and make smart, informed choices.
This impact begins physiologically. “Allostatic load” refers to the cost of chronic or extreme wear and tear on our bodies, mind, and emotions. Allostatic overload occurs when demand on our internal resources exceeds our capacity. The fear and uncertainty fueled by the COVID-19 crisis is putting extreme pressure on our finite resources. The consequences include poor decision-making, breakdown, and burnout.
So how can we take better care of ourselves and build more resilience?
One way is to become more aware of the different selves that influence our behavior in the face of threat and danger. The most defenseless, vulnerable, and childlike part of us is the overwhelmed self. We also have a more capable adult self. Much as a loving parent does for a frightened child, this self can soothe and reassure our overwhelmed self. Unfortunately, when we feel most threatened, it’s our survival self that rushes to our defense — reactively, impulsively, haphazardly, and often counter-productively.
We created this model of the three selves based on work that addresses trauma’s impact on the body and nervous system, most notably the therapeutic model “Somatic Experiencing,” developed by the psychologist Peter Levine.
In survival mode, our vision narrows to the threat, and our pre-frontal cortex progressively shuts down. Reactivity replaces deliberation. Threat can help mobilize our attention, but when it comes to solving complex problems that have multiple variables, we need our highest cognitive resources.
We can’t change what we don’t notice, so the first step is becoming more aware of what we’re feeling at any given moment. That means cultivating the capacity to observe our emotions, rather than being run by them. Simply naming our feelings gives us more distance from them, especially when they’re intensely negative.
The second step is to calm yourself, regardless of what’s going on around you. A simple but powerful way is to use your breath. By breathing in through your nose to a count of three and out through your mouth to a count of six, it’s possible to clear your bloodstream of cortisol — the most pernicious stress hormone — in as little as one minute. Movement is also helpful. A burst of jumping jacks, or running up and down stairs, is a rapid, reliable way to discharge stress and quiet the body and mind.
Once you feel calmer and more able to reflect, it’s possible to step into your adult self. When we embody this strong, empathic part of ourselves, it can care for our overwhelmed self. You might tell this self, “It’s a difficult time and it makes sense that you feel what you do,” or “These feelings won’t last forever,” or “You can feel better, and I’m going to help you.” The most important move is distinguishing between the different parts of you, so you can summon the strength of your adult self rather than feeling whipsawed by your survival self.
By putting our adult self back in charge, it’s possible to move from an enveloping experience of anxiety and fear, to a calmer place in which we’re able to hold and contain our most vulnerable self, so it no longer feels overwhelmed.
Instead, most of us instinctively default to confirmation bias. We seek out evidence that supports our worst fears and disregard the rest. By reacting impulsively and defensively, we often make the situation worse, limiting our options and pushing others away.
When our adult self takes charge, we can also step back and widen our perspective. It becomes possible to make a distinction between the facts in a given circumstance, and the stories we may be telling ourselves. A fact is something that can be objectively verified. It’s incontrovertible. A story is something that we create to make sense of the facts, but it or may not be factual.
Once you’ve made this distinction, it’s valuable to ask a simple question: “What else might be true here?” Rather than catastrophizing about the COVID-19 crisis, you can tap into your adult self, deliberately choosing to focus on what you have the power to influence and letting go of the rest.