What Does COVID-19 Have to Do With Feeling Anxiety? Nothing

CORONAVIRUS CHRONICLES

“Ever since this COVID-19 pandemic hit, I’ve been a nervous wreck,” said a patient in a first session, by phone, of course. So, I’ll ask again, as I asked this new client filled with fear and worry, “What’s COVID-19 got to do with what you’re feeling?” And, so began his transformative journey to calm, peace, and tranquility in the face of a “coronacopia” of life upending challenges.

Helping folks understand this idea, that we are at risk for contracting COVID-19, not emotionally disturbed by the disease, opens the door to greater emotional wellbeing and healthy mental functioning. In a single session, or several (via telehealth), we can teach patients how they disturb themselves by their rigid and extreme beliefs about this-or any disease.

How? Using tools from rational emotive behavior therapy, the grandfather of cognitive behavior therapy, we teach patients to dispute, challenge, and question erroneous, irrational, self-disturbing beliefs that fill them with anxiety and sometimes so interferes with life that it essentially brings it to a crippling halt.

Rather than establish a pattern of negative emotions, we instead teach patients to reframe their thoughts in constructive ways:

• “What am I thinking that makes me feel this way?”

• “Is this thought or belief getting me anywhere positive or is it detrimental?”

• “Does thinking this help me in any way?”

• “Is what I’m thinking helping me build better relationships?”

• “Do I have any evidence, proof, to support this negative belief?”

The aim is to help patients distinguish realistic from dysfunctional thinking. Healthier thinking is a key to coping during the COVID-19 pandemic. Here are some suggestions:

Replace demands with preferences. “It would sure be better not to become infected with COVID-19, but who says I ‘must’ or ‘should’ not?” Of course, it’s healthy to want to be free of this, or any infection, but demanding that you not ever be ill is extreme and will lead to upset.

Replace “awfulizing” thoughts with less extreme beliefs. “It’s not horrible, dire, or catastrophic; it’s really just not good.” “This situation we are in is very bad, but it is not 100% negative.” Separate very bad from more than that.

Replace Low frustration tolerance (LFT) with high frustration tolerance (HFT). “While I don’t like it and sure wish this disease were not floating around and upending everyone’s life, I can certainly tolerate and bear it.” People can stand a great deal more than they give themselves credit for.

Eliminate negative self-other-life downing. “While COVID-19 is not good, life surely still has lots of good in it, as do I.” “I’m a good person, even if I sometimes make myself frustrated with being quarantined.”

Shrink overgeneralizing and employ more evidence-based thinking. “I have no idea if it will always be this way, and in fact, it is very likely not going to last forever. Even if it does, I can handle it, though I may not like it.”

Disclosures:

Dr Mantell earned his PhD at the University of Pennsylvania. He has served as Chief Psychologist for Children’s Hospital of San Diego, the San Diego Police Department, and as Assistant Clinical Professor in the Department of Psychiatry at UCSD Medical School. Website: https://drmichaelmantell.com.