Covid-19 and the Psycho-immunology of Panic

We are living in memorable time indeed.

This article is an exploration of one question: given the current situation, did you reach out for more toilet paper or more connection?

I’m sure you’ve had a thought or two about the toilet paper situation at this point. It’s a global event. I’ve come to see it as symptomatic of what Freud called a cornerstone that civilization requires to exist, i.e., the “renunciation of instinct.”

To put it simply: Id. Primitive, instinctive, unsophisticated Id.

Freud’s original insight suggests that the sublimation of primitive aggressive tendencies is a pre-requisite for civilization. “It is impossible to overlook the extent to which civilization is built up upon a renunciation of instinct…” he noted. The repression of aggressive instincts is perhaps one of the most important functions our ego has. An injured, or maladaptiveego(as we say in clinical jargon), doesn’t sublimate aggression well. Redirected aggression or sublimated anything ideally turns into creativity and curiosity, by the way—both a healthy thing.

A scared human is not a creative, curious human. It doesn’t get simpler. Most of us are familiar with the notion of the “reptilian brain,” and currently, you can feel it right here in your gut – PANIC. The message comes automatically from the survival part of the brain through our bodily sensations, feelings, emotions and thoughts.

It screams: “Hoard, protect, hide, cover. Mine!”

What is furthermore unique during this time is that the message of uncertainty is official. The Covid-19’s response team from the Imperial College in London, which is about as formal and authoritative as one can get, notes:

“We, therefore, conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound … However, we emphasize that it is not at all certain (emphasis mine) that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear (emphasis mine).”

The defining characteristic of a traumatic event is perceived helplessness. Covid-19’s imposition on the changes related to our day-to-day (look at Zoom stock) are less significant than the uncertainty related to its outcome in the long term.

This uncertainty is evident in the questions that are elicited– “How long will it last?” “When will things go back to normal?” “Can I (fill in the blank) while the epidemic is going on?” Short of what authorities are describing as preemptive personal hygiene measures in the social sphere, the truth is that the uncertain is greater than that which is certain now.

The human brain – particularly the amygdala – does not like unknowns. But that’s beside the point here. Let us get back to the toilet paper.

Toilet paper. Toilet paper is panic, it’s primitive, it’s Id. What did we do for all those years before we had any? I wonder! It’s a well-known principle that character reveals itself under pressure. This principle has certainly applied itself in my own life; however, it is also true that many people may not have experienced the level of demand, uncertainty, and dread that Covid-19 elicits. The virus, therefore, has become an induced initiatory experience for most of the population.

“Initiation into what” you ask. Stillness.

One must admit, however, that initiation into stillness implies a privileged point of view. Our current social reality is that most of us are about to have matters made worse by this situation. Unfortunately, wrapping ourselves in toilet paper won’t help.

Medical providers and emergency responders (all of whom will most likely become ill) are running out of supplies and require donations to work.

Additionally, many are at risk of entering into a state of economic duress, which would be compounded by becoming ill: Oh, the medical bills if you end up needing that respirator…!

For those who find themselves in the throes of economic duress compounded by illness or the fear of becoming ill, one word applies: Endure.

It will not help to fight the injustices of the system, or to try to make sense of why airlines get bailouts while we can’t pay our rent. We must pause, take a knee, and learn to calm our nervous systems down. When this is over, the resilience we have developed will allow us to flourish, and to take a stand for authentic independence in our lives.

The wisdom of political resistance applies here: Don’t let the system get you down. Trust me; I’m an immigrant, and I know a thing or two about systemic pressures in this country.

Covid-19 has not diverted the world from its path of economic inequality. On the contrary, it has inflamed it. The clinical consequences are only one side of the problem. I’m not proposing complacency about present inequalities– far from it. Rather, this is a call to see the situation as it immediately demands. Let us fight in one impossible battle at a time.

Let us attend further to the enemy at hand: fear itself.

Intrinsic to this situation and regardless of our economic status is the fear it produces. The brain here enters into a state of acute hyper-arousal triggering our most basic survival complex. This state supersedes our capacity for rational executive functioning, e.g., understanding the contemplation being offered here.

Nature’s design is quite sophisticated, after all, and when ‘shit hits the fan’ we either fight, run, or play dead. Crises unmask us, expose us and make us vulnerable. Such crises trigger every psychological defense available to us. And when those fail? Dread sets in. You know – the “dark stuff.”

The bottom line is this: panic-buying, or pandemic-consumerism, is a symptomatic reflection of a nervous system gone astray.  It is irrational behavior – a mind confused and intensely reactive to its projections, primitive regression, and catastrophic thinking.

This survival strategy has obvious limits, and misses the fact that the same environment that gave us the primitive drive, also gave us the pre-frontal lobe. However, we must decide to access it. Victor Frankl (someone the whole world should get acquainted with right about now if they haven’t yet) famously noted that:

“Everything can be taken (…) but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way”.

Frankl’s was a human insight birthed within a concentration camp. Something similar was suggested in WWII as a morale campaign during the bombing on London – hence the sign. Who would have thought that the British “stiff-upper-lip” could be used as a paragon of sanity for the time?

But accessing the pre-frontal cortex is not just a choice (it is that too). It is a systemic, whole-body, physiological event. It is a central nervous system “state.” And accessing this state, for almost all of us, requires training the mind-body.

You see, stillness and distraction don’t go together. And for the most part, we are all very distracted. We have become accustomed to a way of life in which the virtual domain outweighs our direct sensory experience of the ourselves and the world. Social media and the world of virtual social interactions have made it so that the desired image of ourselves outweighs reality. Covid-19 is a reality testing principle the world was not expecting.

Because we are habituated to the blinding pace of our current world – slowing down will feel initially like a shock. I’ve seen this repeatedly in meditation retreats or in wilderness solos, where students sit by themselves in Nature for several days at time. These practices are thousands of years old, and have been understood for millennia to have tremendous psychological and spiritual significance.

I have certainly experienced this myself. For me, it usually takes about three days of sitting for the static white noise of the city to go away. There is a ringing in the ears that all of a sudden lets up, allowing me to yield and relax; It is something hard to explain; however, it happens to most of us, and nowadays, it’s measurable in a lab.

However, lab measurements of brain wave activities during meditation practice are not the point. Reactionary and aggressive protest around stillness is the point. It almost sounds too benign to be true: defense-against-silence as the core issue. But I propose that it is.

Blaise Pascal noted famously that “All of humanity’s problems stem from one person’s inability to sit quietly in a room alone.”

I don’t know about all, but I certainly know about most. In addition, the incapacity for stillness adds to all the other problems most of the time, because an anxious mind projects fear everywhere and regresses into neurotic self-preservation, as we discussed before.

All of this ends up compromising the immune system. How do I know this? Because stress kills. And if it doesn’t kill you, it will certainly injure you. More specifically, your response to your fear will effect your immune system.

Fear is but a primitive, startle-based survival impulse that, at its best, serves as an orienting function. You want to be able to alert to the danger – and be able to respond to it as the situation demands. But anticipating the punch, blocking it before it comes, countering before the opening is there – all miss the wisdom of timing things. Anticipatory anxiety is a fear-based reaction that is currently making the crises worse. The epidemiology of Covid-19 is irrelevant insofar as the incapacity to sit still with uncertainty goes. More importantly, it misses the insight that this iscontrollable, for each individual through the practice of stillness.

Emily Landon, the chief infectious disease epidemiologist at the University of Chicago Medical School, touched upon this when she noted that “the healthy and optimistic among us will doom the vulnerable.” She went on to say, that we would be right to feel that the strategy of saving the world by “doing nothing” was anti-climactic.

However, “doing nothing” is hardly as easy as it sounds.

It remains true that before this virus, we measured the value of life solely by doing more and more. Be more efficient, more productive, more successful. At what cost? At the cost of all our relationships, the eco-system included. Greed and ambition have no limits, are always rewarded, and “bailed out” when they fail.

It will take courage not to be defined by the pathological lack of empathy that drives so much of this system as it stands.

We text rather than call, post rather than engage, and push the “like” button because it’s just so damn easy. All of which contradicts the existential reality that the deepest communication is mostly non-verbal! We’re not built to look all day at the little screen; we’re made to look at each other. Babies and mothers know this for certain; nevertheless, it is true for all of us. We were all infants once, and we will never outgrow that mirroring. Thank goodness!

As a mental health professional, I am stunned at the lack of public initiatives that address the primacy of mental health in a moment like this. We all need the medical system to work. Jayashri Kulkarni, a psychiatry professor at Monash University in Melbourne, noted recently: “There is a prevailing belief that in any crisis you deal with the physical issues first, then the mental health issues much later. I challenge this view because we need the public to be robust mentally to deal with the challenges ahead (my emphasis).”

A psychology of endurance requires us to “train our minds to desire what the situation demands,” as Seneca noted about 2000 years ago. The current crises requires balance and patience from us. It requires not to get ahead of ourselves, and not to amplify fear and dread.

Sitting still with uncertainty is as simple as it sounds but not as easy you think. All you have to do is sit down, turn everything off that habitually distracts you, and breathe. Close your eyes if you want – it doesn’t matter. Just. Sit. Still. I challenge you to do it! Greater good will come from building this resilience than anything else you can do right now. As a good friend of mine and inspiring artist wrote recently:

We are not in a hurry
We need not run
We are the ants busy building our mound
We are the trees dried and chapped standing firm
We are here for what comes

We are the grass that laid our seed long ago
We are ready for this moment
We are always ready

We know what to do
We have always known what to do
We need not run

~Robert Bellows

washingtonpost.com/health/2020/03/20/emily-landon-coronavirus/

cnbc.com/2020/03/20/coronavirus-tips-for-protecting-your-mental-health-during-quarantine.html

Seneca

Victor Frankl., “Man’s Search for Meaning”

Thiago Leao, author: 
Thiago has worked with veterans for the past 2 years. Originally from Brazil, Thiago has experience and exposure to the harsh realities of social inequalities and the correlated violent outcomes they produce. In Thiago’s view, working with veterans has attested to the conclusion that, as a society we generally have a tendency to offset responsibility for that which we don’t see. It stands then, that, that which we don’t see must nevertheless be dealt with. Nowhere does this become as clear, as in the case of war. In short, the brunt of the equation is that the soldier not only has to deal with the psychological and physical brunt of war – they also, whether wanting or not, liking it or not, become the storehouse of our collective ignorance insofar as our impact on the world goes. In essence, a burden no one person should ever carry.