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Uncertainty, Challenge and Choice during the Pandemic

There is no denying we are in uncharted territory with the COVID-19 pandemic. In the midst of the burnout crisis, how can we possibly rally against this invisible foe without feeling overwhelmed and defeated already? The Upside of Stress, by Kelly McGonigal, suggests that understanding the positive effects of stress may help us maintain a mindset that will preserve our well-being and resilience. Facing uncertainty with an attitude of grit and recognizing we have choice in how we respond to the stressors are vital steps in our self-preservation.


Facing Uncertainty

The pandemic presents a real danger to our well-being and potentially our survival. The stress response associated with this threat may be intense enough to elicit the physiologic ‘fight-flight-freeze’ response. Conversely, stress sometimes triggers our protective desires of caring, cooperation and compassion. In healthcare, we tend to practice the positive responses to stress because we deeply care about our patients and the service we are providing. In an effort to still get our work done we may suppress our emotions as we try to better control our environment. When the stressors are beyond our control. This is where keeping our minds focused in the moment rather than trying to predict the unknown future is important to avoid feeling overwhelmed.


Next steps:

  1. Take time to acknowledge what is difficult in the moment

  2. Identify your emotions and how stress is manifesting in your body

  3. Positively affirm who you are and what your role is in the given situation

  4. Acknowledge that, at your best, you will function within this role


Choose Challenge over Threat

There is psychological and physiological benefit to viewing the current situation as a challenge rather than a threat, and in choosing to be concerned rather than fearful. Keller, et.al. in 2012, studied the perception of stress and how it affects our health. High amounts of stress and the perception that stress impacts health negatively are each associated with poor physical and mental health. If we change our mindset about stress, we can change our body’s response to stress. This technique is called stress reappraisal and it is useful when the stressful situation cannot be changed. “Stress reappraisal is not aimed at eliminating or dampening stress arousal – it does not encourage relaxation or reduction of sympathetic arousal – but instead focuses on changing the type of stress response experienced (threat becomes challenge).” according to Jeremy Jamieson, PhD in Psychology at Stanford. In the current pandemic there is clearly threat, threat of severe illness, death, loss of loved ones etc. However, as a community we have vital functions to perform that are necessary to rise above the threat. Rather than allowing the current situation to freeze our actions, we can develop a mindset of rising to the challenge before us.


Next Steps:

  1. Perceive your stress responses as functional and adaptive

  2. Recognize how you might adapt to the stress is a positive way

  3. Implement these innovative choices

  4. Create routine in your day as you implement these positive changes


Switch from a Control Attitude to a Choice Attitude

Fear can create the need to control our environment. This desire for certainty and control, despite feeling of loss of control can be overwhelming. Rather than asking, ‘What can I control in the given situation?” ask, “What can I choose to do?” We retain freedom of choice in how we respond and we retain autonomy over our own behavior.


Next Steps:

  1. Identify behaviors and skills you uniquely bring to the situation, such as courage or compassion

  2. Be kind to yourself, pausing, when needed, to regroup your thoughts and emotions

  3. Gently remind yourself: I am not the cause of this suffering and I, alone, cannot resolve this suffering

  4. Share that an attitude of choice is available to others as well

Embrace Camaraderie, but Don’t Touch ;)

Social distancing sets the stage to amplify our stress, despite the fact that camaraderie and connection are vitally important to our well-being. Although we face uncertainty about the future, creatively embrace the challenge of how to connect across the divide this pandemic has created. Choose opportunities to connect with others from a distance and despite the barriers. Respond to those who are reaching out to you as well. Despite the restrictions we face, there can be joy in caring for and being of service to those you hold most dear.


References:


2. Does the perception that stress affects health matter? The association with health and mortality. Keller A1, Litzelman K, Wisk LE, Maddox T, Cheng ER, Creswell PD, Witt WP.

https://www.ncbi.nlm.nih.gov/pubmed/22201278


3. Improving Acute Stress Responses: The Power of Reappraisal

Jeremy P. Jamieson, Wendy Berry Mendes and Matthew K. Nock, Department of Psychology, University of Rochester; 2Department of Psychiatry, University of California, San Francisco; and 3Department of Psychology, Harvard University. https://www.psychologytoday.com/sites/default/files/attachments/126767/arousal-reappraisal-review.pdf


4. Optimizing stress responses with reappraisal and mindset interventions: an integrated model. Jeremy P. Jamieson, Alia J. Crum, J. Parker Goyer, Marisa E. Marotta & Modupe Akinola https://mbl.stanford.edu/sites/g/files/sbiybj9941/f/2018_stress_optimiziation_jamieson_et_al_anxiety_stress_coping.pdf





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