Like people all over the world, I now have experience with “voluntary self-isolation” because of the coronavirus. In January, I traveled to Italy with a group of college students only to return home abruptly due to the viral outbreak. Instead of spending spring break in Europe, we made a 26-hour trip back to the United States and entered a 14-day home isolation period. Rather than exploring Italy, we watched Netflix and made daily temperature reports.
While the internet is awash in guidelines for how to practice what we now call “social distancing,” far less is being said about the psychological impact of self-confinement. So, what can you expect to feel if you have to self-isolate because of exposure to the virus or restrictions imposed in your community? I find that the five stages of grief Elizabeth Kubler identified in her work with terminally ill patients also provide a useful framework for working through emotions we are feeling in response to what is becoming our “new normal.”
Denial: Individually and collectively, humans tend to react to threatening news by trying to invalidate the information. They can’t cancel our trip, close our school, or shutter our favorite restaurants when we don’t even really know how dangerous this virus is, can they? Ironically, our lack of knowledge about COVID-19 is the problem. Until we find an effective treatment and can produce and distribute a vaccine, our only option is to spend our daily lives so we can limit its spread. Viewing the sacrifice as something we can do to help others makes it a bit more palatable.
Anger: Many of us find it easier to admit to anger than fear or sadness. This is true in part because anger can feel empowering while anxiety and depression sap our strength. And, of course, it isn’t hard to find things to be mad about. China delayed their response to this novel virus, hospitals in Europe don’t have enough equipment and staff on hand to deal with an outbreak of this size, and our decentralized system of health care has impeded our ability to respond quickly to this pandemic. While anger in the face of frustration is a normal response, it only becomes productive if we use it to solve problems. Clearly, we are all going to have to figure out how to better prepare for the next pandemic.
Bargaining: Who among us hasn’t made a silent bargain with ourselves, God, or the Universe to try to prevent something bad from happening? The problem with such bargains is that they rely on the hope that somehow there is a way to prevent an undesired outcome, which isn’t always the case. When people become obsessed with thoughts of what they could or should have done to prevent a tragedy, we call it counterfactual regret. But it is only when we focus on the reality of a situation that we can create a plan for moving forward.
Depression: Optimism and resilience take energy. In a world of sensational news, unfamiliar threats, and indecisive government responses, it is easy to focus on the negative and to engage in thoughts that generate emotional distress. We know that personalizing problems, catastrophizing about future outcomes, perseverating about how things should be, and thinking in all or nothing terms are sure-fire ways to make yourself stressed. Fortunately, thinking about what we can do to help others, looking for solutions to problems, and challenging our own negative thoughts by generating alternatives and reaching out to others can all interrupt the pattern.
Acceptance: One of my favorite stress management tools is a deceptive little formula adapted from the book “Rapid Relief from Emotional Distress” by Emery and Campbell. The ACT formula, as it is called, is based on three simple steps. First, you have to Accept the reality of a situation. When you get done wishing that things are different, you can Create a vision for how you want to cope with the situation and then Take action to implement your plan. During our self-isolation period, my students and I shared lists of things we are grateful for, exchanged pictures of our pets, looked up internet recipes for Italian food, watched movies together, and talked about their career goals. In the frenetic modern world, we rarely have time to slow down and acknowledge our feelings, to consciously connect with friends, and to think about what we really want from the future. Reframed, self-isolation can even be an opportunity for introspection and growth. None of us expected or wanted this situation to happen, but we can control how we choose to respond.
Mary McNaughton-Cassill, Ph.D. is a professor of clinical psychology at the University of Texas at San Antonio and a Fellow of the UT System Academy of Distinguished Teachers.