There is a prayer, often linked with Alcoholic’s Anonymous (AA), called the serenity prayer, which reads: “…grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” The words are repeated regularly in meetings and the concept helps those in recovery live day to day with uncertainty, never knowing if today might be the day they relapse. This mentality is also one that cancer survivors and those with chronic illnesses have learned to manage as well. As time goes on in the pandemic, this strategy and others from acceptance and commitment therapy (ACT) seem to be skills we can all benefit from learning and honing.
That is because the uncertainty of it, including the length of time it will go on, only makes it more difficult to manage. What might have seemed like something that could be tolerated for one month, is much less tolerable for 6 months, or a year, or some uncertain amount of time in the future. It is the difference between gritting and bearing through a stressor, like getting a shot or going on an airplane, and living with that same stressor persistently. Dr. Keith Humphreys, Professor of Psychiatry at Stanford University notes that in studies of pain, pain is thought of as more unbearable if people don’t know when it will end. He explains, “We are seeing that dynamic in this epidemic: not knowing when relief will come makes everything worse. People thus have to accept two unpleasant things at once, namely that their lives are worse and that they don’t know when the storm will pass.” Not accepting our own limits, Dr. Humphreys notes, can lead to anxiety, depression, and shame.
But, just because people want predictable environments, does not mean the environment is actually predictable. In fact, it is quite the opposite. Dr. Steven Hayes, Nevada Foundation Professor of Psychology at the University of Nevada, Reno and author of a Liberated Mind, explains “we might have cancer right now and not know it, or we might have Covid-19 right now and not know it.” Still, there is a part of us that thinks if we worry enough, we can know all the answers or fix them. Dr. Hayes notes, “your mind has this idea that if I tantrum enough, some reality will care, but the virus doesn’t care if we say we just can’t stand it…we aren’t going to be rescued (like we were sometimes as kids), this is up to us to sort of sit with.”
Pain, like uncertainty, is also an inevitable part of the human experience. This is true not just during Covid-19, but always, like when someone is diagnosed with cancer unexpectedly, or experiences a complicated pregnancy. Dr. Hayes says that people like to think the world is “happy happy joy joy” but “if you live long enough, you start running into pain and illness and loss and tragedies of all sorts. It’s just part of it. That’s part of life.” Learning to accept that, as opposed to trying to change it, can make all the difference. Dr. Hayes adds that our mind also likes to tell us “our future will be better if we worry about it now,” but actually data says when that future becomes now, a person actually does more poorly if they worried about it too much.
As such, it is important that we change our strategies to cope (see: the World Health Organization illustrated guide for more ideas). One important skill to learn is psychological flexibility. Dr. Hayes defines this as “being able to be open to different kinds of thoughts and not have to grab on to truth with a capital T. And, to be open to a range of feelings without having to self soothe in ways that are avoidant and destructive in the long run”(like alcohol use, which is increasing during the pandemic). In a study during Covid-19, those with high stress had worsened psychological problems if they were more psychologically inflexible and pessimistic. Dr. Hayes explains that in all of the data he has studied, the single most important predictor of psychological outcomes was psychological flexibility processes. He says, “what these flexibility processes predict is who is going to crash and burn versus who has got to come on the other side of a challenge like this with post traumatic growth.”
The good news is that studies have shown repeatedly that people can learn to be psychologically flexible. Dr. Rhonda Merwin, Associate Professor and Licensed Psychologist in the Department of Psychiatry and Behavioral Science at Duke University, School of Medicine explains, “Our current situation is more a marathon than a sprint. We need to open up to what is (accept the current situation) and establish new structures and routines.” And now is a good a time to learn. Dr. Hayes adds, “You know, you’ve had a gut punch. Time for a gut check. How are you? How flexible are you? How resilient are you?”
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