Communication is a vital tool in the response to Covid-19. The Taoiseach addressed the nation last week. The Department of Health holds daily briefings. There are regular updates on the websites of the Health Service Executive and World Health Organisation. We have all learned a new language: coronavirus, delay phase, mitigation phase, flattening the curve.
The public health messages and these new terms all make perfect sense. We understand the need for social distance. Some people need to self-quarantine. Others must self-isolate in order to protect their family and friends.
But while all of these messages and measures are entirely logical, their emotional impact can be confusing. We are told that we are all in this together, but we need to stay two metres apart. We must care for the vulnerable, but we must not visit our mothers on Mother’s Day. And, if we are tested, we should assume that the test is positive and self-isolate until we hear the result, even if we now feel well.
All of this makes sense but it places us in a highly unusual emotional and psychological position. Self-isolating while awaiting a test result feels like being suspended in the air mid-way between wellness and illness. You might feel perfectly well, but you are being treated as if you are ill. So, how, exactly, are you supposed to feel? Well or ill? You might be either, or both.
The first step in dealing with this unfamiliar situation is to recognise that presumptive self-isolation is primarily aimed at protecting others. As the HSE has emphasised from the beginning, we are all in this together. None of us wishes to spread the virus.
The second step is to realise that any medical test will always prompt conflicting emotions at the same time or in quick succession. We both want and fear the test result. What if I am sick? And if the test is negative, what caused my symptoms?
The rules of logic apply loosely, if at all, in these highly charged situations. Much of what we feel does not make sense, at least at first glance. Recognising this is important. We like to think that our emotions and inner lives have a certain reason to them, but sometimes we need to acknowledge the existence of a tangle of emotions that we simply cannot figure out.
To complicate this even more, most of us harbour secret worries that we do not share with anyone. Perhaps, at some level, we know that these anxieties are illogical or exaggerated, but, yet, we worry. That is the very essence of anxiety: our logical brain might object, but the anxiety persists. Most of us know that if we can bring ourselves to share these worries with other people, we will feel relieved.
Today, in the midst of the Covid-19 pandemic, we all have both public and private worries. And while we might dismiss certain anxieties publicly, we carry the unease within us until we seek reassurance from a family member or friend later on. Our brains are excellent at finding new ways to worry.
Perhaps the most astonishing feature of our present situation is that, despite our familiarity with our own anxieties, we often fail to recognise that everyone else is just like us: full of secret worries. All the anxieties and confusions that I feel, other people feel them too. So, instead of thinking that you are burdening someone else with your worries, you should know that, deep down, other people share your concerns. They need you just as much as you need them. Other people are just the same as us.
The greatest challenges to reaching out and sharing our worries are these psychological hesitations rather than physical barriers. Of course, in the context of Covid-19, there may be physical barriers too. People who are ill or self-isolating are often most in need of sharing and support. But making the extra effort to connect, possibly by telephone or video-calling, can shift everyone’s energies in a more positive direction and away from endless worries.
Thinking about other people and the world more broadly also diminishes our own individual anxiety. It reminds us that this is not all about ‘me’. In a sense, there is no ‘me’ with Covid-19; there is only ‘us’. Self-isolating while we await test results reminds us that all health is public health. The Taoiseach was right: we can only manage this together.
Brendan Kelly is Professor of Psychiatry at Trinity College Dublin