After several weeks of lockdown, it's possible that for some of us our feelings can become more problematic and less straightforward to deal with. Our Psychosocial Director GRAHAM FAWCETT looks at three sets of feelings that might emerge and how to handle them.
Difficult feelings can emerge from three sources: a deprivation of stimulus (commonly called sensory deprivation or “cabin fever”); an upsurge of feelings related to the past (and which we thought were resolved); and a growing tendency to actively avoid any threat (also called “safety behaviours”).
1. Cabin Fever
This is a well-known phenomenon arising from lacking stimulation or being socially isolated for more than a few weeks. It is partly why so much research is going into how crews will fare on a Mars expedition, and the intense interest in the experiences of those scientists locked down for extended periods at the poles. Common signs include intense restlessness or irritability. Other signs include lethargy, trouble concentrating, sleep problems and food cravings. We are also seeing an increase in more troubling phenomena such as fugue states (losing awareness of surroundings) and other dissociative states such as feeling the world is not real. We are also, rarely, hearing of people dealing with hallucinations.
Cabin Fever symptoms quickly resolve once the lockdown is complete and people can move more freely. The challenge is managing the symptoms in the meantime. The key approaches are establishing a routine and varying our experiences.
It is helpful to set realistic goals for each day and week remembering the effort involved in much of what we now do. It is also helpful to establish eating patterns around mealtimes and to avoid ‘grazing’. Eating at set times helps our bodies to recognise the time, and how much time has passed since the last meal.
It’s also extremely helpful to actively engage our brain by doing things that are stimulating, that have variety, and that open us up to new experiences. In extreme hostage isolation, those that made it through found novel things to consider such as building their dream house in their mind or how a football league will play out over a season.
For those of us in less extreme situations, it is helpful to simply look out of the window and see what new things are out there, deeply noticing the changes that occur or novel events. Shake things up a little by moving the furniture, pictures, ornaments or books. If you are isolating with others then make up games that look for changes in the environment.
Avoid the “same old, same old” in what you can see and hear each day. Having everything the same all the time in your environment is the point at which your mind will start to make stuff up or, deeply, have you ignore the tedium by shutting down. If you can, leave the house for a walk, go onto a balcony or into your compound and look at the world around you from a different perspective. Look back into your apartment or house from a different perspective and see what you can notice.
Finally, speak with people if you are able, preferably using a video link so you can see faces and they can see you. If the symptoms become problematic and start to interfere with your ability to function (e.g. get out of bed, not recall the last few hours, alarm or threaten those who are with you) then it is imperative to get help and advice.
2. An Upsurge Of Feelings About The Past
Feelings about past events – especially if traumatic or frightening at the time – might start to resurface. In this instance, we may experience fear that the feelings associated with the past event are returning.
The most helpful thing to do is some straightforward grounding exercises. Notice the fear and what it relates to, then ask yourself some paired questions. How long ago does the event feel? How long ago was it really? Where was the event? Where are you now? Is here and now safe? Pay deep attention to the "now": what time, date, year is it. And pay deep attention to the "here": the room, town and country that you are in. What you are doing here is placing yourself elsewhere to the historic threat and reminding your brain that there is no current threat.
Breathe. Yes, I know you know this but do it anyway. With a timer (on your smartphone). A controlled breath in, pause, and out, takes at least 20 seconds. Doing that five times should make you a little bit dizzy. Take a pause, then do it again. Notice how you begin to feel as you exhale – that is your mind reminding you that you are safe.
Notice your thoughts. Are you replaying the events? Asking yourself endlessly "why" or "why me"? Notice what you are thinking that is helping you to feel alarmed and so trying to keep you safe. Thank it for doing its best and tell it all about where you are, the date, that you are safe.
If you can, then tell someone. Not about the event, that’s private. Tell them that something bad happened once, that the feelings are coming back, and can the two or three or more of you talk about something else.
3. Avoiding Fear
Avoiding fear, or what we call “safety behaviours”, might start to become more common. We can become concerned, then anxious, then compulsive about cleaning, disinfecting, wiping, handwashing. Doing these things a bit will help, then doing them more will help more, then doing them all the time will help us stay completely safe. Or so the little voices in our heads tell us. Going out becomes a lottery. We stay four metres away from others, rush the shopping and forget half of what was on the list. We feel the bit of our world that is safe begin to shrink, little by little, day by day.
Facing the fear is the hardest part of the response. There’s no proof we will be okay, that outside is safe. And yet we have to live our lives, get our groceries, reduce the risk of infection.
There is a common saying in many languages: “do life scared”. It means "face life and get on with it". But this is actually unhelpful. We have to "do life" for sure, but we should do it with gratitude, with hope and in peace. This is not some peculiar mantra, rather its the aim of all therapy and coaching. When I work with people in fearful situations, I seek ways to calm them in the moment. Typically this can involve stopping and paying attention whilst also relaxing (there’s that breathing again).
And so in a shop, find somewhere out of the way, look at what is available, relax (so you can focus and decide what you need) and be hopeful you can get the things you need back home. Once you’re home, be deliberately grateful for what you have accomplished. When cleaning, pay attention to what you have cleaned and then move on. Pay attention to when you need to wash your hands and begin the habit of asking yourself if you need to wash them again. Notice the thoughts (the little voices) saying “just to be safe, just to be sure” – reassure them and move to another activity.
These behaviours can be quite sticky once lockdown ends. Certainly my parents carried many minor safety behaviours with them (always fill a kettle with water at night – in case we are bombed) to their old age. Equally we can find ourselves phobic, irrationally nervous or dysfunctional when lockdown ends. If this drifts for more than a week or so it will be important to get support from friends, trusted others or perhaps counselling with the aim of getting you going again.
Most of us will be fine. A bit ratty, a bit frayed but fine. Some less so, but things are likely to improve once the quarantine lifts. For a small number some extra help will be needed and that is best sought, by far, early on.