Now that more and more people are getting vaccinated and a return to somewhat normal life is on the horizon, my patients’ anxieties have changed again, many of them worrying about how they will return to public life after having avoided it for a year. While outwardly rejoicing at the reopening of the world, they panicked in private.
While the pandemic has generally been an anxiety-provoking experience, it has resulted in less anxiety and fear for many people in certain parts of their lives. “The Covid-19 protocols not only officially sanctioned, but specifically encouraged, avoidance of the outside world,” said Simon Rego, chief of psychology and director of psychology training at Montefiore Medical Center in New York City. This officially sanctioned avoidance has come as a relief for those who dread certain aspects of public life, such as large crowds, socializing or exposure to germs; they can now avoid anxiety triggers in the name of public health.
Avoidance is a four letter word in the form of therapy that I practice: cognitive behavioral therapy. This is because while avoidance minimizes anxiety and fear in the short term, it maintains them in the long term. “Avoidance prevents a person from learning that the disaster is unlikely to happen, and even if things go wrong, they will find a way to cope and overcome the situation,” said Jonathan Abramowitz, professor of psychology. and director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. For example, people who are anxious about social gatherings will never learn that they can successfully navigate such events and will continue to walk away from them.
Additionally, prolonged avoidance can lead to anxiety and / or fear, even in situations that we have previously found to be manageable, such as commuting to work. “People who regularly commuted in traffic were used to this experience because it was part of their routine,” he said. “But now that it’s not part of their routine, the prospect of commuting is daunting again.”
As we return to “normal” life, we will need to relearn even simple skills that we have not used for over a year. Many of my patients tell me that they can’t imagine dressing properly, let alone going to their desks or to a crowded restaurant. But they also desperately want to see their loved ones and re-engage with the world.
The good news for these patients – and for all those who fear an imminent return to normalcy – is that they can work to gradually re-enter public life, using the principles of exposure therapy.
Abramowitz defines exposure as “a process in which you deliberately face situations that cause anxiety in an attempt to recognize that these situations are not as dangerous or aversive as you thought”. People engaged in an exposure therapy course gradually and systematically expose themselves to people, places, things and / or emotions that they wish to avoid. (While research has shown that exposure doesn’t have to be gradual to be effective, most of my patients prefer this approach.) For someone who shuns parties, for example, this may mean starting with a visit outside with a neighbor and work slowly. to a big event.
If you experience anxiety, fear, or nausea at the thought of stepping out of your covid cocoon, consider following these “exposure rules”:
Make a ranked list of the circumstances you want to avoid: Think about the people, places, or things that make you uncomfortable. These can be general (going to a mall) or specific (an upcoming school fundraiser). Rank them according to what you want to avoid.
Create a specific plan: Start with the lowest item on your list and describe how you will approach this situation. Rego cited the example of people who dread their journey: they might “start by planning a car trip during off-peak hour, accompanied by a person they trust, staying in the slow lane”. When you feel confident that you can handle a certain situation, which may require several training sessions, move on to the next one on your list. If you have something specific coming up that you really dread (a backyard summer wedding, for example), plan exhibitions for yourself before that, so that you feel better prepared when it does arrive.
Be aware of your anxiety / fear: Expect to feel slightly to very shabby during your exposure practices. “It’s okay to feel anxious and uncomfortable,” Abramowitz said. “We are human and we haven’t been through a lot of these situations in a year.” Your only goal should be to get in and out of these experiences, not necessarily enjoy them. (And, let’s face it, even with a lot of practice, you might never enjoy them.) The more exhibitions you do, the more confident you’ll be in your ability to tolerate these dreaded situations.
Help the children formulate an exhibition plan: Children who have been largely isolated in the past year may also be anxious. Children can face a number of challenges when they return to the world, according to Jill Ehrenreich-May, professor of psychology and director of the Mood and Anxiety Treatment for Children and Adolescents program at the. ‘University of Miami. For example, she said, many teens whose “only social outlet has been online gaming” are discouraged by the prospect of returning to socializing in person. Additionally, some young children who have spent unusual time with their parents will experience separation anxiety once their parents resume working outside the home.
Ehrenreich-May recommends that parents work with children of age to create a “sane” exposure plan. “Having a plan really supports children’s feelings of self-efficacy,” she says. “Parents can encourage their children by insisting, ‘We will take small steps and we can do it.’ For younger children, you can define forays into the post-pandemic world as “adventures,” noting that you will spend time trying new things with them and reassuring them that you will always accompany them on these excursions. .
Set expectations with family and friends: Let your loved ones know that you may not come back to life with the same vigor as them. That could mean, for example, saying no to sharing a beach house this summer with all of your extended family (but maybe saying yes to driving to the beach for the day to hang out with them). Abramowitz suggests taking an assertive approach: “You can sit that person down and say, ‘This is something I have to work on. Everyone is at a different level of comfort with all of this. It’s not about you, it’s about me. “
The practice of exposure will not turn you into a type of party life. But it will help you handle the demands of post-pandemic life with more confidence and less worry. And considering everything we’ve been through over the past year, it will look like a big win.
Ilyse Dobrow DiMarco is a clinical psychologist and author of “Mom Brain”, which will be published in May by Guilford Press.
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