As a London psychotherapist in private practice, I have great experience working with anxiety. I encounter it daily in my clients which is presented in the forms of generalized anxiety, health anxiety, panic disorder, trauma, obsessive-compulsive disorder, specific phobias etc.
As of late, the Coronavirus COVID-19 worry has found its way into the mix, affecting individuals who were not previously identified as struggling with anxiety. This unprecedented situation requires me to take a dynamic approach, in terms of both my clients’ well-being and my own. At a moment’s notice, I’ve had to move my traditional face-to-face practice into a digital operation in line with point 91 from BACP Ethical Framework of Good Practice regarding self-care.
The worry of the Coronavirus COVID-19 became real for everyone in the second half of the month. To date, clients have expressed a wide range of responses to the Coronavirus COVID-19 pandemic. Some feel numb and tend to minimise its significance, others feel preoccupied and overwhelmed, where some report excessive worry and fear about the worst-case scenario eg. entailing contamination, sickness and death. While the experience of COVID-19 may be novel, the themes of isolation and existential dread are not.
Anxiety has been part of the human experience from the dawn of time, which is essential to the survival of our species as it motivates us to evolve and thrive. In reality, it is an adaptive response, an emotion that prepares us for danger and enables us to cope under stress. As we cannot eliminate anxiety, what we can do is learn to manage it in order to remain functional in our day to day life.
At this moment in time, the Coronavirus COVID-19 is still new, sometimes frightening, and certainly unpredictable. The best we can hope for is to accept and embrace the uncertainty that comes with it and prepare accordingly.
Learning to tolerate uncertainty depends on which school of thought you abide to. For example, an American psychologist Marsha Linehan the founder of Dialectic Behavioural Therapy, a third wave approach, has developed the term 'distress tolerance'. This entails a set of techniques that can be used during a crisis, when a situation is difficult or impossible to change. These techniques can help us to tolerate short term or long term pain (physical or emotional). Tolerating distress can be helped with mindfulness which includes; mindfulness of breath and a mindful awareness of situations and ourselves eg. breathing exercises, counting to ten, or holding an ice cube in order to bring awareness and acceptance to the present etc.
Furthermore, a British psychologist Adrian Wells suggested that in Cognitive Behavioural Therapy the recommended intervention for managing worries is 'worry management'. Worry management is a set of techniques which can help you reduce the impact of worrying or to solve practical problems. Worry management includes identifying and classifying worries (realistic or hypothetical) and then using either problem solving or 'worry time' to manage these. The rationale behind worry time is to increase your window of tolerance; your threshold to gradually tolerate uncertainty.
An Austrian psychoanalyst, Anna Freud would interpret these approaches as us trying to intellectualise, a defence mechanism, the problem. However, instead of pathologizing our defences - which they all serve a purpose - we need to notice, accept and embrace them as they allow us to move forward. Sometimes it is our stuckness that leads to some kind of psychopathology. Therefore, if we can find ways to enable movement for ourselves and others, we are on the right track.
If you want to find out more about how therapy can help you manage anxiety during the Coronavirus COVID-19 pandemic book an initial consultation.