C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Social Distancing, Not Emotional Distancing

Takeaway

Creating space to recognize and manage feelings of helplessness is critical to prevent burnout and maintain wellness during the pandemic. We share strategies in this piece to help you cope during these challenging times.

“Social distancing” is now part of the public lexicon amid the coronavirus pandemic. The CDC recommends maintaining a distance of 6-10 feet between individuals and avoiding social gatherings. “Limited” is another word that is part of almost all COVID-19 conversations. Limited resources—limited hospital beds, limited capacity to care for patients, limited hospital personnel (doctors, nurses, and all staff), limited personal protective equipment, limited research, and limited scientific knowledge about COVID-19. However, the lasting effect of the pandemic won’t be limited.

 

The need for emotional and psychological solidarity

COVID-19 isn’t just a public health crisis, it’s also an economic, social, and humanitarian crisis. Staying at home for people in our communities who need their jobs and regular paychecks to support their families will have lasting economic and psychological effects. Furthermore, feelings of helplessness, anger, fear, and exhaustion can all lead to unwanted emotional and psychological distancing.

 

The struggle of being a healthcare worker, a parent, and a citizen at the same time is what most of us are facing in this crisis. This is the time that we need emotional and psychological solidarity.

 

As healthcare providers, brief and temporary emotional distancing can occasionally be necessary to prevent paralysis, to be functional and objective in the midst of a crisis, and to take physical care of our patients. However, persistent emotional distancing carries the risk of evolving into emotional numbness. This is when the distancing looks like an inability to engage in positive interactions, open communication, and problem-solving skills.

 

Emotional and psychological numbing presents itself in different ways at different times:

 

1. Muscle aches and tender trigger points

It’s important to remember that emotions are felt as physical sensations and don’t always exist solely in the mind.

 

2. Continuous hypervigilance

This makes us feel like we are always “on” regardless of the circumstances.

 

3. Inability to embrace complexity

 

4. Not wanting to engage in social interactions

 

5. Waking up in the night worrying

 

Healthcare professionals may be at increased risk for PTSD (post-traumatic stress disorder), fibromyalgia, and chronic pain syndrome when experiencing prolonged emotional and psychological numbing. This risk is heightened when feelings of anxiety, anger, and helplessness go unrecognized and unmanaged. What we need in these times, in addition to testing kits and PPE equipment, is space to care for our emotional and psychological health.

 

3 ways to support your emotional and psychological health:

 

1. Create dedicated time for inquiry

This is could look like leaning on community to explore inner self and identifying ways that stress is manifesting. In our department, my colleague Dr. Jena Joy created a “listening hour” a couple of times a week. “Listening hour” is an effort to bring broader awareness of what we’re doing in our lives outside of work.

 

2. Creatively express emotions through drawing, painting, music, or dance

Sometimes, language has its limits to tap into and access our deepest emotions and feelings. Many times I find myself speechless. Expressing emotions by circumventing speech can sometimes be helpful. Drawing, painting, and dancing can help with the externalization of emotions and feelings. In our department, Dr. Somalee Banerjee is hosting a virtual “paint and sip at home” session to create space for art therapy.

 

3. Anchoring ourselves in our body

Unexpressed emotions are often stored in our body in the form of muscle tension, tightness, and other body sensations.

As Dr. Bessel Van Der Kolk describes in “The Body Keeps the Score,”: “if you are not aware of what your body needs, you can’t take care of it. If you don’t feel hungry, you can’t nourish it.”

Cultivating sensory awareness is critical, so that we, for example, don’t mistake anxiety for hunger. Through mindful body movements like stretching, yoga, and focused breathing, we can get in touch with how we’re feeling and ground ourselves in the present experience.

 

We all process and cope with physical, emotional, and psychological stress differently. More than ever, now is the time we need to acknowledge the healing power of community and reach out. Now is the time to lean on our communities to support and cultivate a daily practice of presence and belonging.

 

May you be healthy and safe!