Dr. Brendan Kelly shares an extract from his new book Coping With Coronavirus.
My new e-book, "Coping with Coronavirus" focuses on managing the anxiety and panic triggered by coronavirus around the world. Addressing these challenges involves changes to how we manage our intake of knowledge from the media, how we deal with our thoughts and emotions, how we change our behaviour, and how we see our place in a new and changed world. This adapted extract from the book focuses on managing our thoughts.
Managing our thoughts in a pandemic
Hamlet, in Act 2 of Shakespeare's play, argues that 'there is nothing either good or bad, but thinking makes it so’. Hamlet was both wrong and right. He was wrong because some things, like coronavirus, are just bad. But Hamlet was right in suggesting that our thinking patterns have an enormous effect on what we believe, how we behave and how we feel.
This is never more relevant than during a period of acute anxiety, as is the case with coronavirus at present. Left to their own devices at a time like this, our thoughts will literally run away with themselves and move us ever closer to panic, despite the logical parts of our brains knowing that panic is deeply counter-productive.
Luckily, there are several techniques that we can use to help keep our thoughts more rational and centred on reality. Many of these techniques focus on developing awareness of the unhelpful thinking habits that so frequently affect our thoughts and distort our perceptions of reality.
To this end, the two suggestions here focus on the importance of thinking clearly about coronavirus and avoiding the common pitfalls or thinking errors that so often lead us astray and fuel a sense of anxiety and panic.
Do focus on what you can control in this situation (especially when explaining coronavirus to children)
At the best of times, it is easy to feel overwhelmed. There is even comfort in admitting defeat because it feels like such an admission excuses us from taking action, at least for now. If our problems are too big to be solved, why should we bother doing anything at all? Is there any point in trying?
This remarkably unhelpful psychological manoeuvre results in very short-lived consolation without helping in any way to solve the problems that we face. The key to avoiding this reaction is to differentiate between the overall problem at its highest level and the actions that we can take in our personal lives, which often seem very small in the context of the bigger picture. But that is no reason to step back and give up entirely. It is useful to think of the well-known environmental slogan, ‘Think global, act local’. Small actions matter greatly, both in the bigger picture and in our own lives.
In the case of coronavirus, this means acknowledging the extent of the global problem, but then focusing on what we can do in our daily lives to assist with addressing it: staying informed, following World Health Organization guidelines about hygiene and avoiding transmission, and seeking to carry on with the other parts of our lives as best as possible.
This down-to-earth, pragmatic approach is particularly important with children who pick up on the hysterical tone of media coverage and often ask very direct questions, especially about older relatives who might be at increased risk. Children can express stress through changes in eating or sleeping behaviour, the return of habits from earlier in childhood, general irritation or avoidance of school or other activities.
The best approach is to tell children that there is a problem with a new illness, but that simple things like washing our hands with greater care can help everyone to stay well. Children need reassurance that they are safe. Like adults, they derive great comfort from structure in their day. Children also imitate their parents, so be sure to limit your media consumption, take plenty of exercise and try to maintain the rhythms of daily life as best as possible. When discussing coronavirus, the key is to translate big concepts, which have infinite capacity to overwhelm us, into concrete actions which can both reduce risk and demonstrate the elements of this situation that we can control.
The fact that our individual actions might seem small does not matter. If everyone took these simple steps, such as improving their personal hygiene, the global effect would be enormous. Inaction is the worst of all possible worlds. Edmund Burke, an eighteenth-century Irish statesman and philosopher, wrote that ‘nobody made a greater mistake than he who did nothing because he could do only a little’. With coronavirus, little actions by millions can literally save lives.
Don’t fall into unhelpful thinking habits (audit your thoughts)
Cognitive-behavioural therapy for anxiety disorders and various other psychological conditions has identified specific thinking habits that distort our view of reality and contribute to unnecessary anxiety. Auditing your thoughts for these errors and being more aware of them can help stem the panic that is now so commonly associated with coronavirus.
The first of these errors is ‘catastrophisation’, which is an irrational tendency to believe, and behave as if, a given problem is far worse than it really is. Applying this concept in the present situation is complex because coronavirus really is a catastrophe for many people affected by it. But there is a crucial difference between recognising that something is catastrophic and allowing that realisation to paralyse our thoughts and behaviour.
In the case of coronavirus, rational appraisal of the enormous problems it presents should not catastrophise all of us into paralysis. An awareness of this distinction is vital: we can recognise that something is catastrophic, but we should still rationally assess the size and nature of the challenge, and take action based on that. Catastrophisation and paralysis help nobody, least of all ourselves.
The second cognitive error likely to prove especially unhelpful in our present context are ‘negative automatic thoughts’. These are negative thoughts that we relate to ourselves in disproportionate and irrational ways. They often involve over-generalisation. An example is: ‘Work did not go well today so I am clearly incapable of doing my job’. Or: ‘I forgot to wash my hands properly and therefore I am a useless person’. Or: ‘People are having difficulty controlling coronavirus, so, if I catch it, I will certainly pass it on to everyone I know’.
Even if you dismiss these thoughts seconds after you think them, having these kinds of negative thoughts repeatedly throughout the day will still have an effect on your mood. Other examples include presuming that things are your fault when they are not, or presuming that you will be unable to assist others if called upon. Recognising negative automatic thoughts helps greatly with preventing them and minimising their impact in our lives.
‘Personalisation’ is another common cognitive error. An example is: ‘The event did not go well, most likely because I arrived five minutes late. It is all my fault’. This degree of self-reference can cause problems in relation to coronavirus, most notably if, for example, you read about a case of coronavirus and immediately assume that this will happen to you too. ‘Negative filtering’ is another unhelpful habit, as we tend to ignore information that does not accord with our opinions and concentrate on information that supports our pre-existing negative outlook.
To address these unhelpful thinking habits, it is useful, in the first instance, to have an awareness that these tendencies are common features of our thoughts. Second, simple exercises such as thought-labelling can help greatly, focused on consciously recognising irrational thoughts and labelling them as such in our heads. This reduces their occurrence and helps minimise their effect on our mood.
Brendan Kelly is Professor of Psychiatry at Trinity College Dublin and author of "Coping with Coronavirus. How to Stay Calm and Protect your Mental Health: A Psychological Toolkit" (Merrion Press).
