by Lauretta Young
In these times of conflicting and unclear advice about this virus, and as we learn more day to day, we may be able to reduce some of the uncertainty and fear. A lack of control is one of the most potent drivers of anxiety during all stressful situations and we have that in large doses with the current pandemic.

The good news, from mental health studies over the past two decades, is that exposure to extreme stress does not always result in physical or mental illness. We knew that before the epidemiological studies of Post-Traumatic Stress Disorder (PTSD), but it’s good to remind ourselves. We have plenty of individual role models to look to, such as the late Senator McCain—who was a prisoner of war but who was able to retain a sense of self and do incredible personal and public service, people like Victor Frankl who survived the Nazi concentration camps to write about how he maintained his hope and sanity.

So what can we do to learn from these examples, and from evidence based research about how to maintain our emotional and mental and physical health during times of chaos and distress? Lifetime trauma is unavoidable . There appears to be a window of opportunity to prevent further suffering or actual disease. The really good news is that only about 10% of people exposed to severe traumas of various kinds (including this one) will go on to develop a disorder. This of course also means that some anxiety, worry, and other unpleasant emotions which do not rise to the level of a disease are to be expected. If we understand the difference between normal and abnormal reactions this is the first step.

The second step is to realize what is within our power to prevent worse outcomes. What are those other 90% of people doing that makes a difference? Fortunately we know more than we did in the Victor Frankl era.

The third step is common sense really, but is called in the literature “psychological first aid.” What can you realistically do to reduce your worry and concern? What can you do to make a financial plan, what can you do to help yourself realistically survive. After this planning stage the fourth step is to “put that in the box” and focus on not ruminating.
The only real power we have is to control our own thoughts and reactions. Some stress is good—it motivates action and decisions. Uncontrolled ongoing stress where one focuses on this after good decisions is where the toll comes in. This is an opportunity to practice where we put our focus and energy. This is not easy, it’s hard. Pick your hard.

So the fourth step is to take advantage of what we know. What we have found to be clear is that repetitive talking about the stress does NOT make things better in terms of natural recovery. The older idea of “psychological debriefing” or interminable talking about the stress has very good evidence to not help. This may be a new learning for many of us who had “stress debriefing teams” at our workplaces in the 80s and 90s. Why does this have such a negative effect with more cases of PTSD and other mental illnesses after extensive “debriefing”—probably this is due to making a habit of being stressed rather than focusing on things one is in control of to do now to calm the stress response. There are entire books, scholarly conferences, and journal articles in the evidence based literature devoted to the multiple factors involved in recovery processes.

To focus on just one thing: what we know is that spending time in nature appears to be protective. How can you do that when parks are closed, when you are not supposed to travel or for some who cannot travel? Or when you live in a place where it is not safe to walk? It doesn’t matter if you spend two hours one day or a few minutes per day based on the studies. So here’s what you can do.

If you can go outside to walk do so. If you can outside to sit do so. If you can only look outside and focus on all your senses do so. The key element appears to be to focus on ALL of your senses, not only what you see. But what do you hear? What do you smell?. What do you feel like—the wind, the temperature, the humidity? The more you do this with all your senses you activate the part of your brain that calms the emotional anxiety part. In ”neuroscience speak”—activating the direct experience network of your brain calms the anxiety/emotion part of your brain. You can do this most effectively with nature, based on thousands of studies.

The key is to use your power to focus. What does the ground feel like as you walk. What do you hear? Tune into your curiosity about the sounds which we usually ignore as background noise. Did you know, for example, as you walk along the new Bronson Creek path, that there are about 65 different bird songs now? What does it smell like? Have you smelled the wonderful aroma of blooming cottonwood trees?

So let’s say you cannot do any of these activities. Using your imagination or visual imagery is equally effective. Remember a time when you were outside and feeling perfectly happy/safe/engaged. Close your eyes and use your imagination to really BE there now. The brain studies show that this can be as potent as actually being there.
May you use your power to keep yourself safe and the healthiest possible in this hard time.

Lauretta Young MD is a past chief of a major mental health center in Oregon and Washington. She now does evaluations of veterans with severe disabilities like PTSD and traumatic brain injuries. She has taught at PSU and OHSU in Community Health to help students and medical personnel to learn resilience skills and has a published curriculum for medical students used in several medical schools. Her other interest is bird watching and she donates bird tours to local charities to teach people to learn “mindful” birding as a way to better mental health. You can contact her at jeffandlaurettayoung@comcast.net.