The paradox of social distancing: a necessity with perils of its own to be navigated
As the COVID-19 coronavirus pandemic creeped in from the horizon, it was disorienting and awkward enough to be deprived of handshakes in the name of social distancing.
Even if it’s no longer quite a coin of the realm, the gesture still is crucial to our social fabric and fundamental to who we are and how we convey ourselves: Handshakes set a tangible tone for interactions, research by the Journal of Cognitive Neuroscience has shown in an article headlined in part “Do Not Skip (That) Handshake …”
And as the virus came clearer into focus, it was amply distressing to be denied hugs, a vital element of human sustenance. As renowned family therapist and humanist Virginia Satir once put it, “We need 4 hugs a day for survival. We need 8 hugs a day for maintenance. We need 12 hugs a day for growth.”
While the urgency of those specific needs can vary, experts know, their absence is part of our profound sense of a world off its axis: Beyond those with whom we are sheltered, we at least literally are out of touch … or better be.
“And when we remove that, I think that it leaves people feeling very alone,” said Rennie Shuler-McKinney, director of clinical services and behavioral health at AdventHealth Shawnee Mission. “Although intellectually people understand why we’re doing it, the emotional side (can be) ‘I’m not feeling cared about. I’m not feeling that physical connection.’ ”
Idled hands and empty arms might seem like trifling matters right now as the deadly pandemic spreads.
But that void in essential connectivity stands for another looming calamity that the coronavirus is provoking: a mental health crisis bubbling out of widespread isolation and loneliness, fear, hindered access to resources and even pure boredom.
The sense of deprivation is accentuated by the shutdown of so many institutions and diversions and mechanisms of our collective morale.
Some of us perhaps are missing sports more than others are, and no doubt in the weeks to come we will explore more of that this sense of loss means to athletes at many levels.
But right now part of missing that is heightened consciousness of everything else around us, from what we do have to what we don’t.
And with everything from sports to houses of worship to schools to our very livelihoods and so much more shuttered in substantial ways, there is an agonizing vacuum in place of our most perennially reliable and consuming pillars of life.
With that lurks distressing possibilities that we must take to heart as much as anything else right now.
“One thing I’m really concerned about ... is that we’re really focused on the potential death rate from COVID-19, but we can’t lose sight of mental illness and the potential for increased suicides in our nation,” Shuler-McKinney, who recently has observed an uptick in emergency department visits related to behavioral health, said in a phone interview. “I am so hopeful that that is not the case because ... we are working so hard at reducing suicide and (have) been making some progress.
“We want people to know there are resources available, so we avoid adding suicide tragedies to COVID-19 deaths.”
Her words are jarring but vital.
Because there is plenty we can all do, for others and ourselves, to help minimize this further disaster in the making.
Because this isn’t any more about feeling a passing sense of being off-balance to be shrugged off than the pandemic is about nursing a cold.
“After every disaster, there is concern for the mental health impact on the survivors and communities,” Debra Walker, director of public affairs for the Missouri Dept. Of Mental Health, said in an email. “This pandemic is really no different. COVID-19 will have an impact on the mental health of many Americans.”
One that could have implications for months, if not years.
Naturally, those in the highest at-risk groups (such as the elderly or those with pre-existing autoimmune issues) and now facing solitude and lost independence could be particularly susceptible.
As noted by Walker, the same might be said of children, first responders, healthcare workers, caregivers, individuals with disabilities, non-English speaking individuals, pregnant women and mothers with babies and small children.
Then there are those already suffering from anxiety or depression or battling substance abuse … even if Shuler-McKinney suggested some who’ve been in recent treatment might have better coping skills than others of us right now.
“I’m very concerned about those individuals who, as their anxiety, their fear, their stress, escalates, are they going to relapse?” Shuler-McKinney said.
Between the financial peril hovering over so many and the maddening ambiguity of the time frame ahead, though, just about anyone could be vulnerable to the onset of depression. Especially since it’s not as if this emergency situation gave us a blank slate.
“We didn’t come into this without our own day-to-day stressors we were already experiencing,” said Dr. Julia Thompson, a psychologist at Children’s Mercy. “Everything we were worried about before this happened didn’t suddenly disappear.”
But something else crucial hasn’t disappeared, either: our enormous capacity for resilience and to alternatively pursue our basic human need for engagement.
“Don’t underestimate the ingenuity of humans to find ways to connect,” Thompson said.
She underscored the value in this climate of social media that can otherwise seem the bane of our existence ... albeit with the caveat of appropriate monitoring and supervision when it comes to children. And the impact of going old-school and calling people on the phone. Or in what might be called even older-school simple acts that can go a long way, she knows of some parents encouraging their children to write letters to loved ones.
Asked what we can do to help others, Walker replied, “Check in on your neighbors while maintaining social distance. FaceTime or call family and friends. Encourage others to take care of themselves. Help in the community. And show appreciation to law enforcement and healthcare workers.”
But as ever, only more so now, one of the best ways to take care of others is to take care of yourself first … at least to a certain extent.
Yes, that means applying all we know about keeping social distance and washing our hands often and trying to avoid touching our faces.
In the interests of cultivating mental health, though, it also means a certain mindset of mindfulness.
As defined by mindful.org, that’s in part the notion of trying to be “fully present, aware of where we are and what we’re doing and not overly reactive or overwhelmed by what’s going on around us.”
That can mean the sort of self-care found in exercise, sleep, playing with pets, yoga, hiking, fishing, journaling and more, Walker said.
It can mean anything from being conscious of flowers emerging to expressing gratitude, Shuler-McKinney said.
Anything from understanding it’s natural to feel disconcerted to remembering that every passing day still is closer to the other side of this chaos.
Anything from striving to reconcile what we do and don’t have control of … and that the truth of our broader plight resides between the extremes anyone could be feeling.
At one end of the pendulum, Shuler-McKinney said, is frenzy and panic, people frantically consumed with, “Oh my God, what are we going to do?” At the other end are the indifferent, still going out and socializing or having parties at their house.
Much as we all might have impulses in each direction …
“The middle ground, that neutral ground, is probably a real good place to live right now,” Shuler-McKinney said.
Such a desirable place that AdventHealth shared a list of 10 ways to feel empowered in uncertain times, a list I found so compelling that I’m going to print one out for myself and post it nearby.
Perhaps you’ll find something in it for you, too, something that helps in the moment and maybe will have some lasting meaning going forward, too:
1. Find the good and share it by text, email or social media.
2. Keep perspective by balancing between frenzy and indifference.
3. Embrace time alone and reflect on past positive times.
4. Connect with those alone by phone.
5. Disconnect from news and/or social media for several hours a day.
6. Create small celebrations and then truly celebrate.
7. Express gratitude during each interaction.
8. Breathe fresh air by soaking in the outdoors.
9. Pray or meditate for 10 minutes each day.
10. Feel whole and stay focused on loving others and keeping things simple.
(Those seeking further support can call AdventHealth Shawnee Mission’s Behavioral Health Assessment Center at 913 789-3218.)
There is a long and winding road ahead, one we have to reframe our thinking about in many ways.
The pandemic is a disaster in itself but with the potential to trigger a mental health crisis.
But in a scrambled and even counter-intuitive time when we stand apart because of how interconnected we are, we all need to remember that we share this trauma.
And that we can share the way forward.
“The message is just making sure that (the public knows) there are people that are willing to listen and to help right now,” Shuler-McKinney said. “And we want to encourage people to reach out and not to try to handle this just alone. This could be a pretty devastating outcome if we don’t pull together.”
And move toward getting back in touch in all the right ways.
Editor’s note: Here are some links that may be helpful.
- CDC page on coping during the coronavirus pandemic
- State of Missouri: Disaster Distress Helpline
- Missouri Department of Mental Health
- Substance Abuse and Mental Health Services: Disaster preparedness, response and recovery
- Child Mind Institute, Coping during COVID-19: Resources for parents
- National Child Traumatic Stress Network
This story was originally published March 27, 2020 at 3:16 PM.