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Concepts in engineering do not ordinarily inform psychotherapy (do I hear suppressed laughter?). But if you stop to think about it, the analogies are startling. Both fields are concerned with managing stress. Cables that support the Brooklyn Bridge, for example, were designed to bear the weight of 35,400,000 pounds. That’s a lot of cars, runners, and cyclists. New York City spends millions every year to keep the cables from rusting. That is, it tries to keep the bridge from sagging under all that traffic. Little wonder. The idea that stress can result in deformation is basic to engineering. Likewise, it is basic to psychotherapy where, as a result of post-traumatic stress disorder (PTSD), people walk around literally bent out of shape.
I’ve thought about applying basic engineering concepts to my patients under stress from COVID-19. In particular, I like the idea of “elasticity” vs. “plasticity,” which every first-year engineering student learns. The Non-destructive Testing Resource Center describes the distinction as follows:
When a sufficient load is applied to a metal or other structural material, it will cause the material to change shape. The change in shape is called deformation. A temporary shape change that is self-reversing after the force is removed, so that the object returns to its original shape, is called elastic deformation. In other words, elastic deformation is a change in shape of a material at low stress that is recoverable after the stress is removed... When the stress is sufficient to permanently deform the metal, it is called plastic deformation.
As we begin to emerge from lockdown, are we elastic or plastic? How, in other words, have we endured the stress, and are new types of stress keeping us from returning to our original mental shape?
In this regard, questions regarding the psychological impact of COVID-19 are parallel to those involving its physical impact since, as we now know, affected individuals can have trouble walking, breathing, and eating even after they ostensibly recover. The difference is that while we still have little control over the virus’s physical effects, we can manage how it affects us psychologically.
The point is to take charge as early as possible, and not allow stress to feed on itself and spiral out of control.
My patient Jeremy is a case in point. Jeremy is an Assistant Professor of Chemistry at a university in New York City. Before the pandemic, he was already under stress to publish enough peer-reviewed articles to get tenure. He was advising the chess team, and also coaching Pre-Med students on the Biochem portion of the MCAT. When the pandemic struck, and added the stress of online teaching, it felt like it was all just too much.
“I still have to write those articles, the chess team is preparing to compete remotely, and my Pre-Med students are hysterical. I’m responsible for everyone, including myself — and now it all just got harder,” he said. I was concerned that Jeremy might give up on himself. Maybe quit coaching, or prepping the team. The risk of failing anyone who depended on him might cause him to duck out of the risk, and then hate himself.
So, my first response was to help Jeremy see that he could handle the stress. “Think back to graduate school,” I suggested. “Wasn’t that the hardest time of your life?” Jeremy had to complete his dissertation and interview for jobs. He actually won a two-year fellowship before taking his first teaching position. I reminded him of how well he did. “You can do that again,” I said. But then I realized that he didn’t have to.
I told him that while he viewed himself as the Same Old Jeremy, always ready to juggle multiple responsibilities, everyone else saw him as Jeremy ÷ A Pandemic. They understood the added stress that he was facing, and would obviously cut him some slack.
“Won’t the Tenure & Promotion Committee give you a few more months?” I asked. “If you asked the chess team to practice on their own a few times — maybe recommend Bobby Fischer’s book, or Jeremy Silman, or Aron Nimzowitsch — that would be fine.” I wanted Jeremy to realign his view of himself with how the rest of the world saw him. “It can be hard when we’re caught up in our own stuff,” I said, “to see how effective we’re being.”
If Jeremy was to snap back after all this was over, he had to be strong enough to remain intact. In “elastic” materials, deformation occurs when atomic bonds stretch but do not break; the atoms do not, therefore, slip past each other, and the material can return to its original shape. On the other hand, “plastic” deformation occurs when some of the bonds do break, and the material cannot recover its shape. I suggested that Jeremy think of himself in terms of resisting the effects of intense, prolonged stress. “You need strength enough to push back against stress.”
I’ve noticed over the years that sometimes it’s useful for someone to abstract themselves from themselves, and reimagine themselves schematically — in this case, as a structure subject to lines of force. “If you were a cable on a bridge, don’t you think that others would ensure that you could bear up under the stress?” He could see that. People wanted him to succeed. They understood the stress he was under and they wanted him to prevail.
“I get it,” he said, adding he knew I was also on his side.
In fact, Jeremy started lecturing me about materials science, about which he knew a great deal. We got into tensile strength — the maximum stress that a material can withstand while being stretched or pulled before breaking. It was fascinating.
But the point was to allow him to realize that we all have our breaking points, and it’s necessary to pull back from the brink. COVID-19 has made the load greater, so we have to be more attentive to its potential effects. We also have to acknowledge that if the stress is greater, so is everyone’s understanding — they are stressed just like we are. “You know,” I said, “there is sort of a new stress equation. If our stress-level seems like it’s doubled, we can expect a doubling in how people make allowances for it.”
I suggested that if we proceeded under the old rules — the rules before the pandemic — we would subject ourselves to a level of self-induced, self-magnified stress that would leave use depleted and even, perhaps, be destructive. We had to live under a new set of rules, which required that we come out of our self-involved bubbles and situate ourselves in the world at large.
Jeremy was accustomed to setting his own standards without reference to any external allowances. He had to get over that. For this, he had to learn to open up to other people and ask for allowances, something that he had never done — or even wished to do.
I suggested that if he imagined the situation in reverse, where other people came to him seeking some slack, he would certainly grant it. So, in the end it all came down to seeing himself within a community. “Look,” I said reassuringly, “you already do so much. Everybody knows.”
COVID-19 is forcing us out of ourselves which will, I think, allow us to recover and even better ourselves in the long run.
