Yesterday I received an email from a former client with the subject line HELP!! Six months ago, Angie came to me with contamination OCD. Obsessed with germs, Angie washed her hands and used hand sanitizer compulsively, avoiding touching everything from the door handles to the magazines and armrests in the waiting room of my office. (Just like we all are now.) Working together, using incrementally progressive “exposures”, Angie’s obsessions and compulsions faded, and satisfied, she ended therapy. Then came the Coronavirus and turned Angie’s world upside down!
The CDC is recommending the very behaviors Angie had conditioned herself away from. Her anxiety had spiked, she told me. She was afraid that all the gains she’d made would go down the drain. What could I say to help, not only Angie, but myself, and all of us who are obsessing over the Coronavirus, trying to protect ourselves and our loved ones, while our anxiety reels out of control?
As Angie knew from experience, and we’re all learning right now, germ prevention behaviors like hand-washing give only temporary relief from anxiety. So long as there’s the chance that we’ve missed a germ, our limbic system will continue to pump out fight-or-flight alarms. Angie didn’t want to go back to the downward spiral of stress she experienced with her OCD. She wanted to be able to rest and relax, despite the danger of contagion. As do we all. How can we have any peace of mind with so much uncertainty around us?
Here are the three steps I shared with Angie:
1. Adopt an expansive mind-set. Since sheltering in place, social distancing and washing our hands can only slow down the spread of the virus among us as, we cannot be certain we as individuals will not get sick. The mind-set we want to have will allow for this: When I take reasonable precautions, and accept the uncertainty that remains, I can rest and relax.
2. Resist urges to give in to certainty-seeking behavior. Angie was taking her temperature as many as six times a day, which isn’t recommended by the CDC. Every time she noticed a sensation of a sore throat or feeling warm, she felt anxious. Taking her temperature made her feel better for a while, until the next physical sensation made her anxious again. Angie was programming her limbic system to remind her, with fight-or-flight messages, to keep checking, what I call feeding the monkey mind. When we reinforce this reactive part of our brain, we are not only programming ourselves for more reactivity in the future, we’re decreasing our ability to tolerate uncertainty.
3. Welcome our feelings of anxiety. One of the most powerful ways to retrain the limbic system to calm down is to remind ourselves it is okay to feel anxiety right now. When we open to negative emotions, we give them space to transform, just like a cloud transforming itself in a wide expanse of sky.
Angie now has clear steps to follow so she doesn’t fall into the trap of obsession and compulsion. When she feels an urge to go beyond CDC guidelines—to try to be certain—she can choose to resist it, and welcome the emotions that are normal in this time of crisis. And when she is taking realistic precautions like washing her hands, wiping down surfaces with sanitizing wipes and social distancing, she can remind herself of her expansive mind-set, welcoming whatever uncertainty is there to exist. With these three steps, we can all train ourselves to rest and relax, even in the middle of a pandemic. It is a healthy thing we can do for ourselves, our loved ones, and our community.
I would love to hear how you are doing, and what is working or not working for you. Leave your comments below.
The Coronavirus feels frightening to us, for good reason. Our collective fear motivates us to keep informed and take action to mitigate the spread of this virus.
But when we can’t be certain what is the correct information or what is the best action to take, our prolonged bouts of fear can diminish our physical, emotional and spiritual health. This short meditation is a useful tool to help decrease our stress so we can stay strong and take wise action.
If you find this practice helpful, please share it with others!
After my first child was born, I developed panic disorder. It was horrible. There I was, a first-time mother having panic attacks not only throughout the day, attacks that woke me up at night, and rob me of the precious sleep I needed to care for an infant. I had my Master’s degree in counseling, but it hadn’t taught me what to do about panic attacks. I felt like I was losing my mind, and worse, I was ashamed. I was failing at the two most important things in my life, becoming a mother and pursuing my professional career as a therapist.
Desperate, I began counseling with a really nice therapist. Together we hypothesized that the stress if caring for an infant brought on the attacks, and we explored my past to understand why I was so anxious. This didn’t help, in fact, if anything it made me feel worse. So, I tried every alternative help I could find, from relaxation techniques and meditation to biofeedback. But the panic attacks kept coming.
Then one day, browsing in my local bookstore, a book jumped off the shelf at me. It was Don’t Panic, by Reid Wilson. I began reading right there and then, and within minutes, tears were streaming down my face. The author described exactly what was happening to me, and better yet, he outlined a treatment for panic unlike anything I had tried before. It was my first real introduction to the exposure techniques used in cognitive-behavior therapy. I got to work following the steps outlined in his book, and three months later I was cured of panic disorder.
When it comes to panic and agoraphobia, or any type of anxiety, “trying to relax” only contributes the problem. When we try to get rid of or avoid anxiety and tension, rather than letting them run their course, we are confirming to our monkey mind that anxious sensations are dangerous and could lead to passing out, having a heart attack, going crazing, losing control of ourselves, crashing our car. As a therapist, I help my clients do exactly the opposite. We actually activate anxious sensations on purpose, moving towards them, not away from them. There’s a saying worth remembering when we feel the urge to “try to relax”. “The only way out is through.” It applies to all the fears we are trapped by.
I did not realize it until it was almost too late. I am susceptible to the coronavirus! I was making dinner with a friend who’d just returned from Las Vegas. We were dipping our hands into bowls of raw chopped fresh vegetables to assemble into spring rolls. Suddenly the thought popped into my head that I did not remember seeing my friend wash her hands first. Las Vegas has thousands of people from all around the world, all in close quarters. She could easily have been exposed to the coronavirus and now I am being exposed too. Oh no!
My urge was to ask her to wash her hands, to watch her closely to see if she was touching her face and then the rolls, perhaps even to not eat the rolls. Luckily, I caught myself in time. As an anxiety disorder therapist, I knew what was happening; the unconscious survival oriented part of my brain, what I call the monkey mind, was activated. It was sounding the fight-or-flight alarm, trying to keep me safe. But the notion that coronavirus was a threat to me that day in my friend’s kitchen wasn’t realistic. By following the monkey’s orders I’d be increasing my susceptibility to a bigger epidemic: anxiety. I’d be feeding the monkey, guaranteeing more outbreaks of anxiety.
There are three things I recommend we can do to reduce anxiety and stay healthy in the face of the coronavirus epidemic. First, when we feel the urge to change our normal hygiene habits, ask ourselves what is our basis to do so. Is it anxiety? Don’t make any changes unless they are advised by expert authority, like the World Health Organization or your doctor.
Second, place a limit on your time reading news and social media about the virus. We don’t need to follow every detail. Scary images and words overstimulate the monkey mind, which cannot differentiate between what happened “there and then” and what’s happening “here and now”.
Third, send love to those in parts of the world that are affected by the virus. This can be in the form of prayer, meditation or whatever way you choose. When we send love to others who are in pain or suffering, we are opening our heart, rather than contracting it out of fear. This is the most powerful way we can stay emotionally—and physically—healthy.
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