Mental Health Innovators Ponder the End of the COVID-19 Honeymoon

Dear Mental Health Innovators: The COVID-19 Honeymoon Is Almost Over.

The title of a recent PsychiatricTimes.com article caught my eye. Honeymoon? Then I realized it was dated May 19, so perhaps the authors could rewrite the title with the "Almost" removed.

The authors identify predictable stages of psychological response to our current pandemic. Unbeknownst to those whose education was really less education and more training for their future jobs (so things like history were deemed a waste of time), the human family has lived through past disasters, including multiple pandemics. There are patterns to these things.

Heroic Stage


First comes the heroic stage. For COVID-19 that was this March (in the US - worldwide timelines vary). It is characterized by:

  • high activity
  • high altruism
  • low productivity

Lots of rescue behavior, health care workers putting in insane hours even without protective equipment, companies offering free services...

Open access is the innovation trend for this stage.

I recognize myself in this stage, checking in constantly with everybody, actually feeling rather calm and comfortable as I reverted to my oldest-child-of-dysfunctional-family-with-absent-parents over-functioning. I knew what to do. Fortunately, I was reading a memoir [shout out to Elizabeth Anne Wood's book Bound: A Daughter, a Domme, and an End of Life Story - it's a great book, has nothing to do with COVID-19, but plenty to do with both over-functioning child and dysfunctional health care system] and I recognized my reversion to old behavior before it undid years of therapy.

Honeymoon Stage

Next came April and the honeymoon:

  • high assistance
  • high bonding
  • high optimism

Remember all those articles, Facebook posts, etc. about the "reset" button? Dolphins in the Venice canals, clean air over cities, the ozone hole over the arctic closing? That early, joyous love affair with Zoom?

Platform (apps, websites) is the innovation trend for this stage.

I recognize myself in this stage too, except for that optimism bit. Friends kicked into high gear making masks. Not a seamstress, I contributed fabric. Somebody who was on my rescue list in March volunteered in April to do my grocery shopping for me. But trauma survivor that I am, always scanning, always scanning, I anticipated:

Disillusionment Stage

May and continuing...

  • low optimism
  • high distress
  • high illness

Governments aren't able to stop the spread and are reaching the limits of assistance. Science appears to have failed us with shifting guidance and conflicting sources. People's circumstances are stretched beyond their capacity to cope. The trauma effects are coming home to roost. The guns are coming out.

Turns out, dolphins show up in the Venice canals every now and then; the size of the ozone hole regularly fluctuates. America is done with COVID-19. There is a bull market in denial. Common sense is collapsing. People who just can't bear to stay home any longer decide the whole thing is overblown so they don't need to stay home. Among my friends and family, some have adopted a fierce individualism, "I do me, you do you." Translation: Live your life in fear if you want; me, I have a constitutional right to do whatever the hell I want.

We don't know how long this stage lasts, depends on its depth. Mental health practitioners brace for what they call the "mental health tsunami," with stress symptoms coursing through the population faster than the virus: substance abuse, anxiety, phobias, depression, insomnia, apathy, withdrawal. They think it's time for them to step up to the plate, these symptoms being their usual field of operation.

The authors go to prevention as the innovation strategy for this stage. Myself, I wonder if the profession's traditional focus on the individual, even with their efforts to scale up through use of technology, isn't just bailing the Titanic with a bucket.

So now my symptoms show their petticoats. And I don't plan to avail myself of their tech solutions like wearable devices that signal coming relapse. I mean, really? I need my phone to tell me I'm not doing well?

The prevention strategies the authors recommend, meditation, nutrition, music and art, proper sleep... all with their related apps - again, bailing the Titanic with a bucket.

Okay, they are helpers. They have to believe they can help. My current go-to strategy is:

Catastrophizing

Catastrophizing is the irrational thought that something is far worse than it actually is.

Or is it? What if the expectation of a fascist fall is the rational thought that breaks through the denial of those who still think the center can hold? My current read is An Address in Amsterdam by Mary Dingee Fillmore. This story, set in 1940-43 Amsterdam, feels eerily current, as Jewish families debate in the early chapters whether they need to leave the country. (Is there an app for that?)

The expectation of a short shutdown, a quick economic recovery, life getting back to normal has generated "disillusionment," as the authors so coyly put it.

Myself, I expect the worst. I cancelled my autumn book tour in April. So far my pessimism not disappoint. And if it turns out we're all back to "normal" in October, have I lost that much that cannot be recovered?

The peddlers of hope lose their credibility when that hope proves false. Here is a plea to mental health professionals to not become yet one more institution that disappoints.

Reconstruction

Eventually we get there, a return to:

  • recovery
  • responsibility
  • rebuilding

Past pandemics and world disasters have yielded to surges of creativity and innovation, from the Renaissance that followed the Black Death to the remaking of global structures that followed World War II. It's hard to imagine what that future will look like. The authors have some guesses about the next level of frontier innovations: AI, sensors, -omics, imaging, synthetic biology, smart devices, digital therapeutics... which seem off to me. I mean, that's their profession - they are mental health innovators. But couldn't a pretty strong case be made that the worship of new technologies is what got us here in the first place, from short-circuiting our brains to destroying our planet?

I came out of my personal mental shipwreck a number of years ago with a phrase I have found helpful ever since, "I don't know the answer to that question." What are the chances that humility will make a comeback?

Looking to the future

The article closes with some interesting questions.

  1. How can we inspire, encourage, and retrain those who have been cast aside as "non-essential" in this time? If retraining 20 million people can be quickly achieved, what scalable technological or vocational training can be offered immediately?
  2. In an increasingly non-religious world, what scalable spiritual alternatives can be offered to provide individuals with answers to existential questions like meaning, purpose, destiny, control, and role of the self at this time?
  3. How can we cultivate resilience to ensure society of its capacity to rebuild and redesign our collective new normal?
  4. How can we train individuals to live simpler lives with enhanced self-reliance, and how can technological innovation help?

Yes, I do have to smile at the ambitions of mental health innovators to create scalable spiritual alternatives and to train individuals to live simpler lives - with the help of technological innovation. In a nutshell, I think this continuing to focus on solutions for individuals is not going to lead us anywhere. The solutions will have to start with a recovery of community, with a sense of belonging to and responsibility for the whole.

The article ends with a commission:

Mental health innovators will represent a group of humble, perhaps unsung heroes in this crisis, and it's through collaboration, urgency, optimism, and trust that we will get through this together. It's time for us to get to work - to help, heal, and harness the innovative potential inherent in crisis.

Well, this post is long enough. They do remind us that we have been here before and lay out the roadmap to better days ahead. So I'll just say to these humble unsung heroes,

Good luck with that list. Bless your hearts.

(Colorized) engraving of the Titanic by Willy Stöwe in the public domain
Book jackets from Amazon.com


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