Dr. Charles Silberstein on regaining our equilibrium.
As a psychiatrist, I am accustomed to hearing people talk about marital crises, worries about aging parents and troubled children, struggles with compulsive eating, substance use, and self-harm. But in all my decades of practice, I don’t remember another time when the state of the world was so front-and-center in the minds of almost all of my patients. There is abundant evidence that, faced with the trouble and uncertainty currently overtaking our country, Americans are more unhappy, anxious, and stressed than ever. (See bit.ly/2QwUe9J, bit.ly/31DbUX8, and bit.ly/2HrstP2.)
According to the CDC, in June 2020 40 percent of Americans were struggling with a mental health issue or substance use problem. Central to much of the distress is a sense of helplessness — a feeling that as individuals, there is little or nothing we can do about the pandemic, the political predicament, environmental decline, racial crisis, or the potential economic calamities that loom.
It has been suggested that resilience comes from the ability to tolerate uncertainty and distress. In the past month, I have been asking Islanders and others about their strategies for maintaining resilience. The following is a compilation of some of the most useful suggestions I collected.
Engage in activities
One strategy is to do something — get active. As soon as we are in action mode, the parts of our brains that worry and feel distress get turned off. (This is a key to how mindfulness meditation works. See my earlier article.) Exercise, cooking, reading a book, playing a card game, or just about any other engaging activity at least temporarily turns off the feeling of being helpless. Following a passion wherever it leads you will undermine that feeling a despair. This is why work can be a great tool to enhance resilience. For those who are unemployed or underemployed, volunteering for a favorite cause or embarking on any new project would be a great antidote to helplessness. Now is the time to finally clean out the basement, learn to speak Spanish, write poetry, or repot those pot-bound houseplants.
A recent article in the New York Times presents the strategy of laughter as healing for psychological and physical distress. (See nyti.ms/34pYkZg.) Not only will watching comedy shows and listening to your favorite humorous late-night hosts give you a sense of being less alone, but also, getting a chuckle from the humor involved will help heal you.
Minimize exposure to the news
Many people I know avoid the news, particularly television news. Our brains have evolved to experience visual danger as immediate and threatening, so watching the news or even scrolling through news-related photographs on social media can trigger the stress-related chemicals adrenaline and cortisol. The cyclic repetition of the news makes it all the more disturbing. (See my 2017 article, “Beware the news”.)
The chief operating officer of a large corporation who is now working remotely from his summer home told me about how important news avoidance has been for him. “I rarely read the New York Times and Washington Post anymore,” he says. “And I make a rule of never watching the news. I was just wasting too much of my day and coming away filled with angst. I made an exception with the first presidential debate, and I regretted it; I wasn’t able to pull myself away, and I felt wrecked afterward and didn’t sleep that night. I won’t watch another debate. Since cutting down on the news, I have stopped clenching my jaw and grinding my teeth.”
Take steps to minimize work stress
The same executive went on to tell me how he had also taken steps to disengage from the unhealthy aspects of his work. “I was feeling guilty about working from home until I went into the office a few times and found myself pulled into the office politics, and everyone wanted to meet with me. It is easier to keep a physical and emotional distance from home. Also, if I’m sitting in a conference room with masked people, I can’t read their expressions nearly as well as when they are on Zoom.” He says that he’s learned to use the “lifeguard rule”: Never let anyone in trouble in the water touch you, because they will pull you under. Instead, give them a life preserver to hold onto. In other words, maintain an emotional distance, and stay goal focused. “If I start to get worked up, I disconnect and remind myself that it’s just a job, and the people at work are essentially clients.”
Being as organized as possible also helps, he says. “By keeping lists, I find that things don’t fall off the radar; and when I cross something off of my list. it’s so comforting. Even if I can’t control the world, I am more in control of my work.” He adds one last piece of advice: Given that we are all geographically static because of the pandemic, it’s important to keep moving and maintain our flexibility in every other way possible. He finds exercise essential for physical well-being, and psychotherapy key to emotional health. (His psychotherapy uses a technique called cognitive behavioral therapy (CBT) which he has found enormously helpful. For more stress reduction tools from the world of CBT, see my earlier article.
Increase spirituality in your life
Many people I know experience relief in the spiritual realm. They find an antidote to worry and stress in trusting that the greater order of the universe is in the hands of God, nature, the ineffable, a higher power, or something else that feels bigger than us humans. Common in 12-step rooms is a rock with the words “Turn It Over” imprinted on it. Turn over the rock, and the same words appear. The sense that forces greater than ourselves, beyond our understanding, are driving fate, and consequently giving up trying to control things ourselves, can be enormously freeing.
A recent article in the New York Times discusses “awe walking.” It posits that the practice of walking while consciously observing the wonders of the world around us, as if looking through a child’s eyes, opens us up to awe. Awe is defined as “the sense that you are in the presence of something larger and more consequential than yourself, and that this something is mysterious and ineffable.” Studies have demonstrated that unlike helplessness, awe is an emotion that leads to improved physical and mental health.
Prayer and meditation may offer similar relief. Father Chip Seadale, rector of St. Andrew’s Church, writes, “I like to think that ‘prayer might not change God, but it definitely changes us.’ There are various types of prayer (thanking God, asking God, saying we’re sorry, etc.), but many have forgotten how powerful the simple act of praying can be for one’s spirit … When we pray, we are simply saying that there is a higher power who created us and made all we know and is the One who is ultimately in charge of everything. Not us.” He goes on to say that this “allows us to feel deep gratitude for the things we do have – life itself, people who love us (even if we’ve hurt them), and the possibility of using that relationship we have with our higher power to help us find our way.”
Rabbi Jonathan Lipnick, a part-time Chilmark resident, writes about the idea of beshert, the “preordained” or “destiny.”
“When despairing about the future of America or the world,” he says, “giving up attachments, including the attachment to the idea that we are in control, changes the channel from despair to awe.” He also mentions the importance of community, particularly in light of the isolation often created by the pandemic. “There is a need for communal action,” he says. “Black Lives Matter in Chilmark has been restorative … It is a spiritual act that moves me to action, energizes me. We are wired to be together communally.” Rabbi Lipnick likes to use the term “physical distancing” instead of “social distancing.” Feeling connected to others, which can be achieved in a meaningful way in person while physically distancing, is especially important now.
A wise elder of psychiatry, George Vaillant, M.D., writes that “spirituality is not about ideas, sacred texts, and theology; rather, spirituality is all about emotion and social connection.” In a classic article on positive emotions, spirituality, and psychiatry, he posits that we in the mental health field fail to focus enough on positive emotions — love, hope, joy, forgiveness, compassion, trust, gratitude, and awe. (See bit.ly/3dSE6u4.)
Positive emotions, he points out, “free the self from self,” whereas negative emotions are “all about me.” Helplessness, anxiety, despair, and anger — emotions that the state of the world and our politicians nurture in so many of us — are “all about me.” Conversely, positive emotions are related to people and things outside of ourselves.
I found my conversations with those mentioned above reassuring. It would appear that many have found relief from despair and helplessness in an array of strategies that range from turning off the television to praying. The bottom line would seem to be: Take action, practice positive emotions, get outside of yourself, and connect with others in a meaningful way.
Dr. Charles Silberstein is a psychiatrist at Martha’s Vineyard Hospital and Island Counseling Center, where he is the medical director. He is board-certified in general, addiction, and geriatric psychiatry. He writes regularly about issues Islanders have with mental health.