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On a plane, passengers have neither control nor escape. If something goes wrong, there is nothing they can do. The idea of being helpless when in danger triggers the release of stress hormones. If the stress hormones build up too much, imagination takes over. The thought of the plane falling out of the sky stops being just a thought. Even as the plane is flying fine, the anxious passenger believes the plane is plunging.
Our situation in this pandemic is similar. We have neither control of the situation nor a way to escape it. The idea of contracting the virus can release stress hormones. If the thought persists and stress hormone levels build up, we — like passengers on a plane — may lose our ability to separate imagination from reality. The thought of being in intensive care can overtake us even as we go through the day in good health.
If someone confronts us with the fact that we don't need to be so distraught, we may justify our distress by saying, "But it could happen." This statement suggests there is a benefit to making an imaginary disaster real in the mind. It may be a form of magical thinking that gives us the illusion of control. By imagining disaster, we stave off real disaster. This illusion of control has a price: stress. And stress, if chronic, damages the immune system our life depends on.
To avoid falling prey to the imagination, we need to protect our ability to sense what kind of mental processing is going on. This ability has several names: meta-awareness, observing ego, and the one I prefer, reflective function. When the reflective function is active, imagination — even vivid imagination — is fine because are aware we are engaged in imagination. We know what we have in mind is not real. But if stress hormones rise high enough, reflective function collapses. When that happens, we no longer know what we have in mind is imagination. Imagination is experienced as perception.
To protect reflective function, we need to do at least one of the following:
- Reduce the release of stress hormones. Stress hormone release is inhibited by oxytocin. To reduce stress hormone release, we link an oxytocin-producing memory (nursing an infant, holding a newborn, sexual afterglow, sexual foreplay, interacting with a pet) to the situations and thoughts that release stress hormones.
- Increase activation of the parasympathetic nervous system. It overrides the effect stress hormones have on us. It is activated by signals from the face, voice quality, and touch/body-language of a person we feel completely safe with. To activate the parasympathetic nervous system, we link the memory of such a person to the situations and thoughts that cause stress hormone release, and to what we feel when we become stressed.
The following exercise is adapted from my books. For flight anxiety: SOAR: The Breakthrough Treatment for Fear of Flying. For panic, anxiety, and claustrophobia in day-to-day situations: Panic Free. For pandemic-related fear and anxiety: Panic Free Pandemic Workbook.
We separate and neutralize each component of hyperarousal. As we do the linking, we keep thoughts about these components from triggering additional stress hormones by imagining a cartoon character is experiencing the component.
Rapid Heartbeat
Superman is disguised as Clark Kent in his business suit. He notices an increase in heart rate. That means some evil person nearby has kryptonite. The cartoonist has drawn exclamation marks on Clark Kent's chest to indicate a pounding heart.
- Pretend your friend is holding the cartoon touching their cheek.
- Pretend you and your friend are looking at the situation Clark Kent is in. Imagine talking about it.
- As you talk about the cartoon, imagine your friend is giving you a reassuring or an affectionate hug.
Rapid or Difficult Breathing
Imagine Popeye is with his girlfriend Olive. Popeye starts to feel edgy and decides to fortify himself with some spinach. Reaching into his pocket, he finds it empty. No spinach! Popeye panics. Stress hormones push him to breathe faster than is possible. To illustrate this, the cartoonist draws Popeye with his fist wrapped around his neck, saying, "Olive, I can't breathe!"
- Pretend your friend is holding the Popeye cartoon touching their cheek.
- Pretend you and your friend are looking at the cartoon and are talking about the situation Popeye is in.
- As you talk about Popeye in the cartoon, imagine your friend is giving you a reassuring or an affectionate hug.
Hot and Sweaty
Imagine SpongeBob triggers stress hormones and he starts to sweat. Imagine sweat dripping across his face.
- Pretend your friend is holding the SpongeBob cartoon touching their cheek.
- Pretend you and your friend are looking at the cartoon and are talking about how SpongeBob is feeling.
- As you talk about SpongeBob in the cartoon, imagine your friend is giving you a reassuring or an affectionate hug.
Derealization, Dissociation, Disorientation; Feeling Unreal or Surreal; Looking at Yourself From Outside Yourself
Imagine Scooby-Doo locked in a kennel. Being in a place where he can’t escape makes Scooby nervous. The cartoonist draws stars and exclamation marks spiraling around Scooby's head to indicate that things feel unreal, or surreal.
- Imagine your friend is holding the Scooby-Doo cartoon touching their cheek.
- Pretend you and your friend are looking at the cartoon and are talking about feeling is derealization, dissociation, or disorientation.
- As you talk about Scooby in the cartoon, imagine your friend is giving you a reassuring or an affectionate hug.
Tension in the Body
Imagine Dr. Bruce Banner. Stress hormones are released and he begins turning into the Hulk. His chest gets huge. Buttons pop off, as he is filled with body tension.
- Imagine your friend is holding the Bruce Banner/Hulk cartoon touching their cheek.
- Pretend you and your friend are looking at the cartoon and are talking about the feelings happening as Bruce Banner turns into the Hulk.
- As you talk about the cartoon, imagine your friend is giving you a reassuring or an affectionate hug.
In addition, see this recent blog post on Psychology Today.
