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I had a cat named Fiona, she was famous for her athletic abilities, just like Fiona May.

As soon as you left her with an unattended bag she would dive headfirst into it: she would stand still for 3 seconds, and then her little face would pop out of the bag, she would look around and with a quick movement, she would go back to scratching the bottom of the bag. She could go on for half an hour until the most terrible thing would happen… she would get stuck in the bag’s handle.

And then off she would go, paw on the accelerator, wheel spins better than a Ferrari, running out of control banging into anything that stood between her and her escape from the imminent danger… the attempts to calm her where vain, until chance or the bag’s aerodynamic in acceleration, or the stool in the corridor, would make the handle untangle setting her head free from the imminent death threat so that everything would go back to being normal and playful, just like before.

Well, during these days I have seen a lot of crazy “Fionas” on the news!

Just as I would have liked to explain to Fiona that running madly around the house would not help her to set herself free from the bag, today I would like to help all the other thought endowed “Fionas”  to free themselves and to learn to handle Coronavirus anxiety, that feeling of fear, and panic to which, each one of us, during this time, is called to respond.

On the premise that knowing things helps us to handle them or at least to feel free to choose how to behave, today I will not speak as a photographer but as a psychotherapist to shed a little light on this “infodemic” (“an overwhelming amount of information, some of it completely untrue, that makes it hard for people to find reliable sources when they need to” Cit. WHO Report) that comes with the Covid-19 pandemic.

Fear, anxiety, and panic… what, when and why

coronavirus anxiety anticipatory anxiety
©Aaron Tilley

Let’s make things a little clearer. When we refer only to fear, joy, sadness, surprise, disgust, and rage, we are talking about emotions. These are strongly connected to primal instincts: such as (sexual) reproduction, defending family and (social) species and self-defense/survival (auto-conservative instinct). They are completely functional to the survival of the individual, they are our compass, each one of them presents itself with a clear message, and that’s why we should always listen to them and we should let ourselves be guided by them in our behaviors along with our rational side. All anxious people would probably now think “there’s no way I’m being guided by emotions, only fools (and this is to be polite) do that, we have to act according to our “gnegnero” (a Florentine word that means reason)”. Dear anxious friends, know that if you feel that way that’s exactly because emotions scare you, maybe, if you want to feel calm, it’s time for you to accept them and let them flow.

Anyways, going back to our opening speech, all the rest, is not emotion, they are states of mind or feelings.

And now let me explain to you why they are different:

Emotions are innate, reactive and automatic responses to an external or internal stimulus, they trigger a physiological activation that is needed to face the stimulus that has caused them. They have a great intensity but they don’t last very long. So fear is an emotion that activates in an automatic way when we perceive a real imminent danger and it prepares our body to confront that danger, but how? There’s a gland in our brain, and specifically in our limbic system, which is called amygdale, this gland activates and sparks a series of responses that affect our movements, our hormones and our sympathetic nervous system (the one that controls our involuntary motor functions) so our heart rate goes up to pump more blood into our muscles, that are needed to flee; our breathing is more intense so we have more available oxygen; our muscular tone increases until we even start to shake; our digestive functions decrease because if we need to escape from a lion we sure do not need to eat and digest.

When an emotion is not completely understood, processed and integrated, it comes in contact with our system of beliefs and values (aka our mental rumination), and so it transforms into a state of mind.

Just to be clear, states of mind are emotional traits that are more or less stable and recurring, resulting from our temperament and our personality and they distinguish the background mood. Thus they are far less intense than emotions, they are not a response to a specific stimulus and they have a minimum psychophysical activation. We can define them as shades of emotions with a little bit of cognition.

To be clearer, sadness becomes melancholy or nostalgia; rage becomes frustration or helplessness; fear becomes super scary anxiety.

So anxiety is nothing but a reaction of fear for an event that is normally not considered so scary, but that our head, on the other hand, thinks is very dangerous. So, when we feel anxious we should immediately ask ourselves what kind of unprovoked fear we are experiencing deep in our minds, because most times, the fears we think about are hypothetical, future or maybe fixable. The problem is that we enter a swirling cycle because there is never an end to the negative hypothesis that we can find by continuously mentally ruminating.

coronavirus anxiety Panic disorder
©Josephine Cardin

And, as though that was not enough to make our mental and physical health shake, know that we could have a nice panic attack, the fear of fear, it’s like an emotion multiplied. It begins suddenly and it generally reaches its peak in only 10 minutes, it comes along with a sense of imminent danger or catastrophe and with the urgency to run away. You can have palpitations, sweating, feeling of asphyxiation, chest pain or discomfort, nausea, vertigo or lightheaded sensation, shivers, vamps of heat, the imminent fear to go crazy and to lose control or de-realization. It is scary but fortunately, it doesn’t last for long. The main issue is that, after the first attack, we can feel anticipatory anxiety, namely the fear of feeling it again, which will start to affect our lives and our mental health until we decide to ask for help from a psychotherapist to understand where this is coming from. Panic attacks are not a disorder themselves but a symptom for several disorders that belong to the anxiety spectrum, as I like to put it, they are like a wild card. The point is that a panic attack is a big wake-up call: “Houston we have a problem”… and it is time to solve it!

After this “short” explanatory premise, which results from my known summarizing ability, I would like to apply everything that I have mentioned above, to the historical moment we are living caused by the Coronavirus.

If you think about it, it is perfectly normal and adaptive to feel fear, because this virus is objectively a danger from which we are called to defend ourselves. A lot of you will go through those physiological activations that I have mentioned above, such as tachycardia, stomach-dropping, feeling your chest tightening, maybe you will go through sleepless nights, you will feel nervous, irritated and intolerant. Know that it is completely normal, so don’t feel weird, sick or like you have issues, it is a normal reaction to the danger and the reclusion we are going through. Of course, if you felt these sensations even before this emergency phase, well maybe it would be best for you to talk to someone about it to solve the situation the minute the lockdown ends.

 

Why each one of us perceives fear differently?

This is a good question, in the end, the danger is the same for everyone, but everyone perceives fear differently. Of course, this depends on our personality, on the story of our lives, on our experiences, beliefs, on our values and preconceptions, on pretty much everything that makes us unique. But one thing that affects our feelings is our perception of risk concerning danger. I’m not fooling with you, risk and danger are different things and to make it even harder I will also mention the exposition to danger.

Constriction anxiety
©Matteo Rigosa

How does the dynamic between these three concepts work? Simple: getting sick from Coronavirus is a danger, i.e. an objective and ascribable situation that can cause damage to someone. Risk represents the probability and the subjective perception to get sick. Exposition refers to how much a specific situation can be potentially risky to contract the virus. In actual fact, someone that comes from Codogno, who is more exposed to the contagion, has a perception of the risk of getting sick that is surely higher than someone from Matera (at the moment Basilicata is the region with the least number of Covid19 positives).

But there are other variables that affect our perception of fear and at this point the recent guidance document on the communication of the environmental risk for health (EpiAmbNet-CCM, Health Ministry) comes in handy. Let’s see what they are:

  • Voluntariness: if the risk is voluntary, it’s perceived as low; if it is imposed by others or if we have no control over it, the risk is perceived as higher. As you can understand the Covid19 epidemic is out of our and authorities’ control.
  • Knowledge: as we know well, the things we don’t know scare us the most, so it’s obvious that a virus that was unknown until now and for which we don’t even have a cure, causes concerns. If we then add that a reversible risk is less scary than an irreversible one (in this case we fear death) and that a risk connected to natural causes is less scary than one provoked by someone (here conspiracy theories do nothing but increase discomfort), let’s say that fear surely increases.
  • Trust: if we lay trust in the ones who manage the risk, we perceive it as lower. But if we get continuous information that undermines health institutions questioning their work, or if we get different currents of thoughts and bickering in the scientific world, it goes without saying that trust decreases and the perception of risk increases. Try to compare the two sentences pronounced by our Premier Giuseppe Conte: “We are part of the same community, let’s stay apart today to embrace with more warmth and to run faster, tomorrow” and by United Kingdom’s Prime Minister Boris Johnson:” Many more families are going to lose loved ones” and tell me which one of these inspires more trust!

Some of you, who stoically managed to read up to this point and to follow the drift, could ask themselves “how do we explain the flow of people from the North taking walks on the seafront in Versilia or the mass escape to the South? Shouldn’t they have been the ones with the highest risk perception?” Good observation and I’ll try not to answer too fast and judgmentally. Because there are other two variables in the game, our defense mechanisms from fear and our way to react to it.

 

How do we defend and how do we react to fear?

Each one of us has indeed a personal perception of risk, just like each one of us has an unconscious mechanism of defense against fear and a personal way to react to it. Fortunately, we are all different but the emotional and behavioral ways of reaction to an event that is perceived as dangerous, are the same for everyone. This is why even if we’re almost 8 billion thinking heads in the world, we often find ourselves doing the same thing.

loneliness
©Richard Tuschman

Let’s be more specific. Unconscious defense mechanisms that are activated on the emotional side when there’s a danger, are denial or its opposite, which is phobia, that can take you to the extreme, to actual forms of panic.

We deny something that creates in us an emotional activation that’s too intense, that we are not able to handle, so we pretend that the danger does not exist. On the other hand, we have seen that fear is, in fact, functional to the individual to react to danger, but when it’s overly amplified and unmotivated, it turns into a phobia. This brings us to exaggerated and dysfunctional behaviors that have nothing to do with the main event that has caused fear.

Does this remind you of anything? Like queues at ski stations, or drinks at “Navigli” (canals) or assaults on supermarkets? It’s easier now to understand the behavior of some people that we’ve seen on the news and that we’ve judged so soon with peremptory comments. We may not agree but we now surely can understand why they did that.

They are behaviors that come from our defense mechanisms from fear: when fear is too much to handle, we deny it, we pretend it does not exist and so we all take a  trip together to the sea, there’s the sun and we’re in the fresh air. But when fear takes over we feel crushed, we run away to find shelter with our loved ones or we fill shopping carts with food so we won’t starve.

 

Seven rules against panic

I know, I know, you only started reading this article because you wanted solutions for you unmanageable anxiety and now I will give you what you wanted. But keep in mind that just reading all the previous speech, can help you to feel relieved. If you are really in a hurry (but then again what could you possibly be doing?) here are some ideas  to handle your coronavirus anxiety:

  1. Make peace with your emotions

The first thing to do is to accept the fact that you feel fear, that you are worried, anxious, frustrated, angry, nervous, sleepless and panicked. Know that all of this is a normal reaction to what’s happening. Don’t wear your superman or wonder woman cape, because the more you pretend to be a superhero the harder these sensations will make your chest tighten and will keep you up at night.

  1. Listen to what they are telling you

Take time to be alone, sitting or lying down as comfortably as you can and start asking yourself what are your emotions telling you, what’s the message that they are bringing to you.

Here’s an example: “I have Coronavirus anxiety”: We have said that behind anxiety there’s fear, so ask yourself what’s scaring you right now? You may come up with more answers, very good,  write them down and read them one by one carefully, paying attention to how you feel as you are doing it.

thinking about themselves
©Paolo Barretta

I want to give you two more tips about rage and sadness so you can practice better. Keep in mind that rage is activated when we feel threatened  (maybe in our self-esteem), or when we perceive injustice,  frustration in our needs, or when we are not guaranteed a right. Try to identify the reasons for your rage, who provoked it, who you are directing it to.

Sadness, on the other hand, is an emotion that drains our energy and our will to interact with anything and anyone, because there’s probably a loss we need to process. It’s not only about losing a loved one, but it could be the loss of a job, of freedom, of a possibility. Sadness helps us to direct our attention to ourselves to process a pain that needs to be listened to. Don’t think that sadness will go away with time, if there’s a wound, you will need to disinfect it to make it heal.

  1. How are you reacting to fear

If you have read everything I’ve written, you’ll understand what you need to do from the title. Stop and think about how you are reacting to fear: are you avoiding it by undermining the situation? Are you exasperating it by engaging in behaviors that don’t make you feel good? Write down all the behaviors that you engage in and that are dictated by fear. Let people around you help you because sometimes they are more objective than us and are not as emotionally involved as us. Separate adaptive behaviors and maladaptive ones and keep them at hand because you will need them.

  1. Put your heart and head together

Now look back at your list of fears,  match it to the list of your behaviors and find all the possible connections. Ask yourself in which way they can be connected. Take the list of your maladaptive behaviors and ask yourself from which of the fears that you’ve found are they affected?

Now think about replacing them with more adaptive behaviors, think about acting as there was no fear guiding you. Always write down everything and read again.

Now it’s time for fears, which ones are real and which ones are the result of your mind ruminations? Can I do something about the real ones that can actually help? If yes, what can I do? Make a list of all the real actions you can do and do them, one by one. If not, let it go, you can’t control everything, this pandemic is an example of it. Make peace with your need of control, take your hands off the reins and ride in the carriage, let yourself be transported, it will be wonderful to discover how less tiring it is to let yourself go with the flow instead of trying to handle everything.

  1. Conscientiously aware
 Surrounding yourself with pretty things
©Joel Robinson

We’ve said that knowing things helps us to be less scared of them, but avoid calming your anxiety by continuously checking the news on every channel available. We’ve seen how information is often steered to create a state of alarm in those who are reading, so they develop the perception of danger that’s useful to implement behaviors of prevention and containment. Too much of a good thing. The opposite thing happens and you go into a state of acute anxiety. Give yourself one appointment a day with information and only choose reliable sources, like the ones from the Government or the Ministry of Health. When you feel the impulse to look up symptoms of coronavirus for the umpteenth time on your phone, slap yourself on the hand, just like the Pope did to that Chinese tourist and try to calm yourself down on your own, using your logical and rational side. If you really can’t help it, call your doctor, or one of the regional reference numbers, they will give you the right information to feel calmer.

  1. Get drunk on endorphins

Here comes the best part, make a list of all the things you like to do, and I mean all of them, even if right now you can’t do them. Think about what it is about them that brings you joy and organize your days enjoying at least a few of these. Don’t just say you are fine when you are with your family, it’s too generic, make a precise description of what makes you feel good, like “I  like it when my partner plays train with my son and my daughter and I make up stories about the passengers of the train, we laugh a lot”.

  1. Emotions are contagious

This is more a thought on which to reflect upon than an action to take. Know that emotional states are contagious just like yawning. And this is not a cliché, its scientific truth lies in those neurons that are in our brain and are called mirror neurons. So if you feel anxious, you will pass that anxiety on to the ones near you. Instead, if you are happy, the people near you will smile with you too. Let’s infect each other with wellness.

I wish I could reward all those who managed to get here: thank you very much, you have been stoic! I do hope, however, that it has been well spent and that your coronavirus anxiety has become more tolerable. I would be happy to receive your comments on how you live your anxiety, how you react to it and especially what helps you feel better. Sharing positive and constructive things can also help others. Otherwise, you can always write to me!

Comments

Carissima Laura
Molto utile grazie!
Devo dire che ho avuto la fortuna di incontrare una psicoterapeuta cognitivo comportamentale prima di tutta questa situazione del virus e in quarantena forzata sto mettendo in pratica quello che ho appreso. Soprattutto la pratica di mindfulness mi sta aiutando a vivere ogni giorno con lo spirito giusto.
Bacini

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