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Honor Your Fears: A Hypochondriacs Guide to the Corona Virus

Are you over-reacting? Are you under-reacting? Taking this all seriously enough, or maybe taking it way too far? The thing is, there isn’t really any way for us to know how far is too far.

As a therapist I am often in the business of being a barometer for clients’ reality testing. There are many issues around which this absolutely works. Assessing the risk of the Corona Virus isn’t one of them. While I am able to stay incredibly informed about what we currently do and do not know, and what experts in the field recommend as appropriate precautions and safety measures, this pandemic is able to stir fears in the heart that no one can say with even an ounce of certainty are unrealistic.

To be clear, I personally lean toward under-reaction in life, and even my own version of snarky, critical optimism. Throughout my career however I have worked with folks with varying degrees of hypochondria, paranoia and nihilism. Here is what I don’t base my treatment intervention on; I don’t minimize, and I don’t offer false reassurance based on my own assessment of the “reality” of their fears. To do so is presumptive arrogance that assumes I know the truth and that their sense of the world is inherently distorted.

Facts Matter

Certainly, there are times when it is clear that someone has a distorted take on reality. In those cases, there are clear facts that I can help them note, and see what the barriers are to the client accepting and digesting those facts. In these past couple weeks, I have made sure to help clients distinguish fact from fear for sure, but there is an important fact that is driving peoples’ anxiety, which is that we don’t have all the facts.

About the virus, its symptoms and means of transmission, we have a fair amount of specific information. When client’s anxieties and fear fantasies about transmission and if they themselves have the virus, I rely on facts to help them distinguish between realistic and unrealistic fears. The thing we absolutely cannot know are the implications and extent to which this pandemic is going to last and the resulting repercussions. We don’t know how badly this is going to impact people’s financial functionality. We don’t know what aspects of life as we know it are going to shut down and for how long. We surely all have opinions about it, but we have absolutely no testable hypothesis at all.

I have a couple clients having down-right apocalyptic visions of the coming months. A couple feel quite certain that we will see a complete collapse in society’s capacity to function and will literally lose all production, utilities, banking, and medical industry, requiring survivalist skills. Some folks reading this will think those fears are complete bonkers. Some folks might share a version of this anxiety but be afraid to talk about it for fear they will appear unhinged.

Personally, it is not my opinion that society as we know it is about to end. But that is only an opinion, and I wouldn’t dare attempt to falsely reassure someone about something that is opinion based. I do however want to help, and part of that is helping to alleviate debilitating levels of anxiety. There are two main tools I have available to support clients with fears inaccessible by facts; honoring their fears with actions, and helping them develop self-reassurance skills.

Honor Your Fears with Actions

Worried you are going to run out of supplies? Stock up. Obviously, don’t hoard, but stock up. Have what you feel you need.

Worried you might get the virus yourself? Have a plan for how your family and friends are going to safely take care of you.

Worried banking systems are going to fail? Withdraw as much cash as you can. Stock up on supplies now. Plant a garden. Get some chickens.

Worried you will need to move out of a dense area in a hurry to a more isolated location? Start building your packing list, maybe even collecting your supplies in certain areas of your living space.

Worried you might need to immigrate to another country? Do the research about how immigration typically works in the countries you are considering. Find out the current process. Get the paperwork in case you want to start it. Start the process if that is what needs to happen to contain your anxiety.

Worried the virus might take your life? Get your affairs in order. Wills, powers of attorney, account and passcodes for everything you need your family to have access to. Write letters to your loved ones if that is what is needed to appease your worries.

I get it. Some of this sounds so extreme. And most folks won’t feel a need or desire to do any of this. But if these are the things keeping you up at night, take your fears seriously. Figure out what things you would do if you knew your fears were accurate and do them. Especially if you are someone who others consider to be over the top in worrying on a good day, and are used to having people dismiss your fears. Don’t be yet another person who disregards your fears. Honor them. With action.

Mind you, you are unlikely to be able to get your loved ones on board with a belief that some of these measures are necessary. You might be able to get them on board with helping you prepare yourself as a means of supporting you. They might actually need distance from your preparation because of the anxiety it produces in them to hear about your predictions. You must honor their fears as well and allow them the right to some optimism.

Know How to Talk Yourself Off the Ledge

Sometimes what folks need help learning to do is offering themselves reassurance when they are scared. In those cases, we can explore what interfered with them developing and being willing/able to implement those skills.

Reassurance is frequently required in childhood. Children have lots of fears, realistic and not so much. Folks who know how to reality-test and reassure themselves learned how to do so from someone, usually a primary caretaker. If they didn’t, then they spent their childhood quite frightened, and must learn these skills as adults. Here are some examples of how we use facts and reassurance to help children contain their fears.

Example One

The first big fear most have as kids is monsters of one sort or another. When my son was around 18 months, he was afraid that a cow would come hurt him in his crib at night. Mind you, we live in the suburbs. 

So, first, I applied fact and reason. I noted the absence of cows in our area. I noted the size of the windows compared to the size of a cow. I reminded him how insanely our dogs barked when a leaf blew by the front door. Facts would help ease some of his fears, but not quite enough. 

I remember in a conversation with my own psychotherapist about why I didn’t want to participate in the lie of the tooth fairy. I was making the argument that essentially I wanted to be a reliable source of truth for my child and not participate in lies about fairies which then made space for believing in monsters and other such nonsense. He responded that monsters were real. When I retorted, he clarified; monsters are real in the unconscious. That as much as I wanted external reality to be the only variable, I was forgetting our imagination, which also needed to be addressed.

So, after telling my son all the ways a cow could never get into the house, I then reviewed what would happen if one did. Basically, I took his fear seriously. I told him about all the fantastical ways the dogs would attack the cow. I physically mimicked how our cat would claw at the cow. And then I took each of the stuffed animals he slept with and demonstrated how they would beat up the cow, always ending with the favorite, which was the stuffed horse who would kick the cow until it retreated. He would then smile and point to me. It was at that point, with his fears sufficiently minimized, that he could acknowledge that if he was compromised, I would come running. 

Example Two

Another common fear, or rather realization when children are quite young is that people can die, at least adults. Every parent knows that moment when a child asks if their parent is going to die. Most of us have an overwhelming impulse to respond in the negative, assuring the frightened child that we will surely not be dying. This however, is the wrong answer.

The right answer starts with facts. If we have no relevant health condition, the answer is that we are likely to live a very long time. That most folks grow to be quite old before they die, and that the child will likely live well into their adulthood, might have a partner and even children of their own long before we will die. 

That isn't the end of the answer, because that fact that we probably won’t die for a long time still leaves the possibility that we might. The next step in reassurance is to let the child know what would be true if we died prematurely. We would review with them all the people in their life that love and care for them. We would talk about all the ways these people would step up in our absence. We would talk about the ways we exist inside them, and in experiences and memories, and if we have a spiritual or religious belief system, we would share our thoughts on ways we would be present for them after life.

Adult Application

If our fears and anxieties were sufficiently addressed as children, then we internalize the process of containment of those fears. We know how to review the reality, and then soothe ourselves with what we would do, or what would happen, if indeed the worst-case scenario happened.

When I have clients who have not developed these skills sets, I do for them the same thing we would do for a child, or a friend, or ourselves: I test their fears against reality, and then we brainstorm and plan for the worst case scenario so that no one is left to wonder how they will survive.

The Current Pandemic

All of us should be concerned right now. What is happening is a big deal. The current situation  requires big changes on our part, at least temporarily. Panic is never our friend, but fear is a potentially useful push towards attending to a dangerous situation. We do not need to agree about all of the dangers linked to the Corona Virus. But each of us should be allowed to take our fears seriously.



Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the  Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on needs and issues as well as personality and style.All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing. Request an Appointment Today.

If you were interested in this blog post, check out some of these:

How Does Psychotherapy Help?

How Can Therapy Help When the World is the Problem?

Life Isn’t Easy or Fair: Idealization Tortures us Thinking it Should Be

 

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Author
Full Living Founder and Director Karen L. Smith MSS, LCSW Karen L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.

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