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09 April, 2020

The “three Rs” of anxiety management in the COVID-19 pandemic: Reframing, recovery and resilience

With the COVID-19 coronavirus outbreak bringing new changes and uncertainties, Professor Jim Lucey joined Sean O'Rourke on RTÉ Radio One to look at ways we can manage our anxiety and build our resilience during this unknown and challenging time. You can listen back to the discussion and read the full accompanying blog from Professor Lucey below.

Keeping calm

Anxiety is a normal response to stress. Our distress during this pandemic is understandable. This is a painful time for many people and a challenging time for many more. Our aim must be to prevent anxiety from taking over our life.

Keeping calm

Panic is never a helpful response. To paraphrase our Taoiseach during his COVID-19 statement some weeks ago, “anxiety also spreads like a virus”; panic is contagious. To survive this crisis and come out it in better shape, we must learn to take better care of ourselves and of each other. We must learn the “three Rs” of anxiety management.

In this piece, I will describe these three skills - reframing, recovery, and resilience - and finish with ten practical steps any of us could take to manage our anxiety. There is nothing unusual or exceptional about these calming actions.

So how can we “keep calm and carry on”?

Reframing

Reframing is the basic skill of anxiety management. It is essential. We must start by understanding our fears and knowing where they come from. Then we must reframe that understanding in a more functional way.

Reframing

All our worst fears relate to three core agenda: anxiety for ourselves, our future and our world. This cognitive triad described by Aaron Beck is a summary of the core concerns of every human being. All fears are subjective. We can change them. At times of stress, it is natural that we fear for our own safety, we fear for our future, and we fear for the survival of our environment. Our environment includes our personal environment, as well as the wider one, our community and our shared home.

Instead of being frightened about these three agenda, we could value them. Our values are things that we hold very dear. We value our life, our future and our world, and so we must take care of all of these. Awareness of our values empowers us. By reframing our anxieties into values, we move our anxiety into a better space. With awareness, we can make better plans to support and defend the things we value. Our awareness moves us into more constructive action. Planned action is the antithesis of panic.

Reframing our anxiety about the COVID-19 pandemic is possible by replacing our worries with positive values. This means putting a greater value on ourselves, a greater value on our future, and a greater value on our world. By reframing each anxiety as a value, these agenda become something we must care about, not just worry about, and our concerns are transformed into constructive responses. Awareness of our values mobilises coherent action, which will reduce our anxiety. This results in a mutually beneficial reframing cycle.

The healthy value of reframing goes as "anxieties into values into awareness into action".

Recovery

To recover from COVID-19, we need to believe in recovery. This belief is a faith in our capacity as a people, as a nation, as a species to overcome not only the rising tide of zoonoses (infections arising from other mammalian species and transferred into human beings), but many other challenges arising in the modern world. Belief in recovery is essential for survival. Without this belief, our anxiety will rise. We would be in a state of panic.

Recovery

We can be the authors of our recovery. These are stressful times. There are more stresses to come. A fuller awareness of the scale of our environmental hazard is mindful. Our time has been called “the age of anxiety” - and with good reason. The world is warming, species and habitats are under threat, wars are constant, and millions of people endure forced migration and modern-day slavery. Anxiety is a normal response to all of this.

To mitigate our anxiety and find solutions, we must believe in recovery. Recovery is a process. Research has told us what this involves. Recovery happens when we invest in five things known by the acronym “CHIME”.

The CHIME framework of recovery is:

Connectedness

Hope

Identity

Meaning and

Empowerment.

To put it another way, recovery is a process enabled by connecting people with hope, respecting their identity, giving them meaning and empowering them to work to this goal.

Belief in recovery is a cultural necessity at this or any other stressful time.

Once we believe in recovery, we can unite around these recovery principles. Engagement in recovery will be transformative. It could redefine our understanding of our life. This time, recovery must be something more than an economic recovery, although economic recovery is essential. This crisis is another opportunity for a new and healthier perspective on our wellness.

This is a time to rediscover what I like to call the “Seven Forgotten Truths of Health Economics”.

  1. Markets are human. They are moved more by sentiments than by products
  2. Sustainable economic growth depends on societal health. A recovered economy must be a healthy economy. There is only one kind of sustainable economics and that is healthy economics.
  3. All markets return to the mean, eventually. This crisis will be followed by another.
  4. There is no wealth without health. We can no longer say “it’s the economy, stupid!”. We need a healthier economy, and that’s not stupid.
  5. Individual health is dependent on public health. None of us can be well alone. We depend on each other for our health.
  6. There is no public health without mental health. The other contagion is anxiety.

Resilience

Resilience is the ability to bounce back after a crisis. After COVID-19, we can be resilient. We will not be a weakened nation if we prepare for the next crisis and the next opportunity.

Resilience

Research tells us what makes for resilience in people and in society. We can build upon our resilience by enhancing the six domains of:

  1. Education
  2. Security of base
  3. Our social competency
  4. Our friendships
  5. Our talents and interests and
  6. Our positive values.

Think of these resilience domains as sources of our elastic energy. These are the drivers of our recovery. We could discuss each of them, but there will be time for that again.

One example of the resilient power inherent in these domains is worth mentioning now. It is education. We have an educated population and we are more resilient because of the fact. The leaders of our past who extended access, free as of right, to secondary and, later, to third level education prepared us well. They thought they were preparing the nation’s youth for its opportunities. They may not have known that they were preparing our people for its challenges.

Across the world, access to education is very different. We should be very proud: our educated population has been responsive to its experts and listened to them. We have been led by people with education and expertise and we have been educated in our response. It is hard to imagine this occurring in a society without our investment in the resilient resource of education.

We need to do better with other domains of resilience, but we will do.

Following ten practical steps

To conclude, we can manage our COVID-19 anxiety more effectively by reframing our worries, believing in our recovery, and building on our resilience.

Following ten practical steps

I will finish with this list of ten practical steps to overcome the anxiety of the COVID-19 pandemic; hopefully you will find these helpful.  

  1. Take the COVID-19 precautions seriously: Wash your hands: dirty hands are weapons of mass destruction. Keep your distance: self-isolation and physical distancing will save lives.
  2. Listen to the experts and value what they say (for example, Dr Holohan, Ireland’s Chief Medical Officer).
  3. Learn to be quiet for some part of each day. Be mindful, or pray, or just limit your exposure to the 24-hour news cycle.
  4. Take some exercise every day, in your home, on the couch, or wherever you are.
  5. Reframe your worries: think of them as your ‘values’ rather than your ‘fears’, then act.
  6. Believe in recovery: support the things we know make recovery possible.
  7. Practice hope; it is never naïve. Hope is essential.
  8. Stay connected with those you love: reconsider social media. There’s never been more ways to keep in touch.
  9. Discover meaning in your life; focus on it, whatever it is
  10. Become resilient. Do this by growing your resilient domains, your talents and interests, your friendships and your positive values. Take your time at this. Time is not our enemy: it is our opportunity

Listen back here

Listen back here

Continue to…

Knowing when to seek help for our mental health during the coronavirus outbreak