While COVID-19 is taking an obvious toll on physical health, with more than 23,000 deaths worldwide, its emotional impact is at least as intense. Many people are anxious and uncertain — afraid they or their loved ones may be sick, afraid for their bank accounts and retirement plans, afraid of how long they’ll be trapped inside and generally afraid that whatever future awaits after the virus may be very different from the past.
Experts say forced lockdowns can trigger mechanisms in the human body a bit like imprisonment. Adrenaline and hormones such as cortisol are released, triggering acute stress. Blood pressure, the heart rate and pupil dilation all increase, generating a classic “fight or flight” instinct.
The American Psychological Association has coined a new term for the stress created by the unprecedented situation: “Coronavirus Anxiety.”
Mental health experts are on the frontlines dealing with this second pandemic of fear, and the Jewish News spoke with several Jewish mental health professionals about what people are telling them.
Audrey Jung is a licensed professional counselor who has been in practice for 25 years. Having worked closely with first responders, she knows how important it is to make herself available to people so they can process whatever they’re going through.
“At this point, I’m just trying to help people cope,” she said.
People are trying to come to some form of acceptance of what is going on. Over the course of a week and a half, she has witnessed patients go from thinking this is merely interesting to suddenly worrying that “we can never leave our house again.”
“People are trying to figure out how they’re working to squish the curve, so to speak,” Jung said. They’re “mucking” through it. Some are looking around and feeling uncomfortable and hurt and angry about what people around them are doing, while others are breaking it down into increments of how they’re going to deal with it, she said.
Jung, who works with the post-confirmation class at Temple Emanuel in Tempe, where she’s a member, usually talks to kids about dating and relationships. Right now, she’s Snapchatting them and letting them know she’s here.
Daniel Levi, a licensed clinical professional counselor, said he has seen anxiety increase, because the “theme of uncertainty is dominating mindsets.” He acknowledged that people who have conditions such as anxiety disorders, PTSD and any trauma-related conditions have had those magnified as things get more intense.
Levi wants to “help people get grounded and get their minds cleared again.”
Some therapists recognize that they are also at risk.
Judith Freilich, a psychiatrist at The Meadows, writer and someone who has been through trauma herself, said, “Even as experienced as I am, this is bringing up anxiety, as it has for most people.” Listening and comforting as much as possible are key to helping people get through this, she said, as is trying to stay positive, even though it isn’t easy and can’t be constant.
Room for hope
Others have found their clients to be managing fairly well.
Joan Matlock, a licensed marriage and family therapist, has been pleasantly surprised because people haven’t been “as freaked out as you think they might be.” Rather, she said, it’s an added layer to what they’ve already been going through.
“I’ve really noticed some of the resiliency in some of my clients, especially those who suffer from anxiety. They can put it in perspective because they’re not feeling the physical effects, so they’re using the opportunity to use the skills they’ve developed,” she said.
Jack Silver, the director of training and Jewish counseling for Jewish Family & Children’s Service, handles many older adults and said since Tuesday, March 17, he has been meeting with them by phone. So far, he said, “nobody is overly anxious or wigged out,” and they seem more worried about the stock market and toilet paper than becoming ill.
The people he talks to are doing a good job keeping informed about health recommendations, and Silver encourages them to keep doing that, offering himself as an example. He’s encouraging them to use self-calming techniques like good, deep breathing.
Silver said following CDC guidelines to flatten the curve is good advice, and it’s important not to catastrophize. Thus far, he has been “pleasantly surprised they’re coping pretty adequately so far,” though he acknowledges that “cabin fever is inevitable.”
Time for telemedicine?
While Silver is someone who would rather meet with people in person to get a better sense of what’s going on, Jung says now is the time to explore telemedicine. She was an early proponent of the technology and has seen the risks and rewards of a digital setting.
She said that while the younger generation is much more comfortable and are digital natives, older people may have “integrated to the land of online media,” but they still may not be comfortable with a therapeutic interaction online.
Jung said that people benefit when she is able to extend the “therapeutic space” with a client by giving homework through a portal which makes it a longer interaction. However, funding for these sessions is not uniform, which leads to some difficulties for counselors and their clients.
Levi, who is relatively new to Scottsdale, said that telemedicine has been something he’s relied on as he travels between here and Chicago. He said that for it to be equal in therapeutic terms, you have to have had a session or two in person so that the connection is a lot stronger once you’re using video.
He also pointed to some potential problems. For example, there are factors that can compromise people such as if a mom is sitting with her kids nearby while she is talking to him. Those are things that will have to be managed for it to be as effective as in-person sessions.
‘I had to stabilize myself first’
Matlock said that self-care is particularly important in this moment, but it often gets shunted to the side, especially by women who are used to taking care of others. Focusing on ourselves doesn’t mean we are being selfish.
“Taking care of ourselves is part of tikkun olam,” she said, which is a novel concept for people.
“I’m in the boat with everyone else; that never leaves my awareness,” Matlock said, acknowledging that she had to stabilize herself before she could help her patients.
Meditation, mindfulness and breathing techniques are recommendations all the therapists stressed to deal with the anxiety COVID-19 has created. They practice these things themselves as well.
Levi finds comfort in nature and finds himself going to the desert, hiking and meditating. “That keeps me cleaning out and recharging.”
Freilich said that something as simple as breathing is important. She explained that people who have experienced trauma often react by automatically holding their breath, and right now when we’re trying to keep our respiratory systems safe and protected, it’s important that they fight that instinct.
She said that walking slowly, letting your feet touch the ground, breathing into your whole body while getting energy down to the soul of the feet where it connects to the earth will be helpful.
Mental and spiritual health are connected
Levi, who belongs to Ahavas Torah and Makor in Scottsdale, said that it is important to focus in on gratitude and build spiritual connections. He is reminded that to think the coronavirus or any disease runs the world, “is antithetical to Jewish tradition.”
Freilich, who is part of Ruach Hamidbar, a Jewish Renewal group in Phoenix, said that “mental health and spiritual health are absolutely connected.” She suggested that dealing with anxiety in a way that’s spiritually based is helpful.
Silver spoke of one client who attends Chabad and has received significant support from them because they call and check up on him, making him feel important. But he acknowledges for a lot of Jewish people, religion isn’t their first line of support.
Though that may be, Freilich said, “it does take an element of faith and awareness of the larger community to realize that things can be lived through that do not feel livable in the moment.”
‘Time for the world to develop its empathy muscle’
Freilich knows that all of this is subject to change and that what we face is a great unknown. But, she said, “It’s also a chance for people to take really good care of themselves,” and that in itself is “a gift to the world. People are reaching out to each other.”
“What I would hope for is that there would be connectedness and compassion for your fellow beings rather than a grab-it-for-yourself attitude,” she said. JN