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Psychological Impact of the Pandemic: Part Three

Dr. Brian Stagner, TPA Director of Professional Affairs, Associates for Applied Psychology

 

This four-part series is offered to summarize what we know about the psychological responses to the present crisis. It covers the effects of quarantine and the effects of economic downturns, how to help clients and the public, and concludes with ways to lead during and after the pandemic.

 

Part Three

 

Helping Clients - And the Public

While some individuals will present with clear symptoms that meet criteria for a major psychological problem (e.g., agoraphobia, major depression, etc.), many more will manifest a mixture of stress responses at subclinical thresholds. While initially transitory, these adjustment reactions can fester over time. As the pandemic persists, the initial (mal)adaptations to the ongoing crises can morph into dysfunctional habits or lifestyle impairments. We have specific treatment protocols for specific disorders. We also need to foster healthful adaptations.

 

The importance of Information

During World War II, the anthropologist Gregory Bateson was asked how to boost morale in Britain. He examined child rearing practices and systems of government in England vs Nazi Germany. He concluded that nations which pushed top-down authority and quelled dissent (e.g., Germany) the best strategy was to present a triumphalist message (Victory is at Hand!). It would be important that citizens not lose faith in their government’s mastery of events. Panic is prevented by reassurance that it’s going to be ok.

In more open societies that valued rational debate and discourse, the most important issue was to make sure that citizens did not lose faith in their government’s honesty. (We lost heavily at Dunkirk but we put up a great fight and we did rebuild and prevail.) People will pull together and make sacrifices for the common good so long as they believe the sacrifices are asked in good faith.

The take-home message is two-fold. First, with ourselves and our patients we need to be disseminating information that is accurate and useful. Be vigilant about the distinction between facts and assumptions/suppositions/projections. Avoid quoting information of uncertain provenance. Decline to forward information that does not have some sort of action plan with it.

Example:

                “Our county will run out of ventilators by next Thursday.” (Says who? How do they know?)

versus

“Our county health department has predicted a shortage of ventilators by next Thursday.”  This is better, but it is still pretty useless information and will only heighten anxiety.  Likewise, announcing that the stores are running out of toilet paper promotes panic hoarding. Much better to point out that stores are resupplied overnight and encourage off-hour shopping.

It is human nature to share observations and vignettes, and stories that heighten drama are overvalued.  If it is not going to be useful or helpful, don’t say it.

Second, psychologists are leaders in our communities. We need to support and encourage the dissemination of accurate information from civic authorities, as well as from social institutions. If you encounter suspect information, check it out (try snopes.com, or other fact checkers).

 

Self-Efficacy and the Importance of Routine

It is well established in both laboratory and real-world settings that self-efficacy is associated with subjective well-being, career success, and positive health outcomes (Carey and Forsyth, APA). Furthermore, this is a trait that is malleable---it can be learned and improved upon (Bandura, 1997).      

People and social institutions have had their daily routines demolished. Some activities dropped out, others are added in, and nothing is on schedule. Establishing a healthy new routine that is predictable pays long term rewards. It is a concrete expression of self-efficacy. Individuals, businesses, agencies, and congregations benefit from predictable times/places/platforms for self-care, wellness, productivity, and social connection. Rituals should be preserved as much as possible.

 

Social Networks are Essential to Public Health

The tendency towards isolation under stress is exacerbated by the need for social distancing. Patients may need encouragement to mastery the technological solutions (e.g., ZOOM). Those who are feeling despondent may be energized and empowered to reach out to neighbors from a distance. Sit on the front porch and wave at joggers and the dog people. Leave notes for your neighbors (You ok? I’m making a run for take-out; can I bring you something?). Empower everyone to leverage little gestures.

All of us may benefit from a refresher course on dealing with bereavement. It is going to come up in many unfamiliar ways. A patient’s parent may be on a ventilator. Your ZOOM happy hour leader is suddenly gravely ill, or a revered public figure succumbs unexpectedly. There are many resources about grief and terminal illness available online. (Google what do you say to a dying person. Sample several sites and craft your own responses). Your patient may be fine but will ask for guidance about how to help others. Be prepared.

 

References

Bandura, A (1997) Self-Efficacy: The exercise of control. New York, NY: W.H. Freeman.

Carey, MP & Forsyth, AD. (undated) Teaching Tip Sheet: self-efficacy. Posted at https://www.apa.org/pi/aids/resources/education/self-efficacy

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Dr. Brian Stager is the Director of Professional Affairs at the Texas Psychological Association. He also serves as an American Psychological Association Council Representative. He is a therapist in Bryan/College Station.

 

Read the Conclusion

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