Dr Sarb Johal is an expert in emergency management and disaster psychology. His advice has been central to our government’s world-leading Covid-19 response, and he’s helped NZ, the UK and WHO develop psychosocial responses to crises such as H1N1, the Canterbury earthquakes, and the Christchurch mosque attack. This is an extract from his new book Steady: Keeping calm in a world gone viral.
This extract has been abridged for length.
If you’re lucky, by now you’ve had a period of time where restrictions have eased. Hopefully you have been able to get on with life, more or less as normal. You didn’t have to think about every little action and you didn’t have to worry so much, so you may have been able to let go of some of that anxiety. Maybe you’ve even become a little complacent with things like hand washing and physical distancing.
Philosophers call this feeling of stability our sense of ontological security and it hinges on three factors:
1. A stable sense of home,
2. A feeling that nature is benign, or, at least not out to get us, and
3. A sense that our contract with society and our fellow citizens is not harmful and preferably positive.
When you’ve experienced a time of relative freedom, hearing that the virus has escalated and we have to move back into restrictions or lockdown again can come as a real shock. It knocks our confidence in the systems that are supposed to ensure our safety, like border controls and contact tracing, especially if mistakes have been made. It turns out that we are less safe than we had thought, and so our threat system experiences this as real and present danger, even if the actual risk remains small.
That can bring up all sorts of emotions. You might feel shock and bewilderment, or a sense of dread. Here we go again. You might feel frozen or paralysed by the threat of the virus.
Have you ever driven past a car accident? For a moment, the risk of driving is brought to life – not in an abstract way, but in a vivid, tangible and terrible way. You might slow down and take a long look at what happened. You might then drive on, but much more slowly than you were driving before.
But how long does that new behaviour last? I’ve asked many people this in workshops, and the general answer is a few minutes. For a brief time the accident pierces our protective bubble and threatens our sense of ontological security. But very quickly, our perceptions of invulnerability return and we soon speed up again.
In this way, we are engaged in a constant balancing act – to recognise a risk, but to avoid obsessing about it. To take stock of the possibilities, without allowing awareness of possibilities to stop us from doing what we are doing. We have to build up our capacity to get on with things, or life will completely paralyse us as we check each small detail for risk.
If and when fresh restrictions are announced and you feel that rising dread that indicates your ontological security is threatened, the first step is to take control of your calming system and disengage your threat detection system. This will give you some breathing room so you can make good decisions and judgements. Even though your brain is telling you there is a real and imminent danger, the health risk is still very small, especially if you keep taking basic precautions like following hygiene protocols.
Understandably, with fresh restrictions people will also have a part of their mind focused on the future threat of trying to earn a living, or trying to save their businesses from going under. Governments need to understand that this can become a critical driver of behaviour, so this fear needs to be factored into messaging to help keep people safe as they try to navigate their everyday activities, and also in terms of the practical assistance they may need.
As we have seen in previous crises, it is often these secondary stressors that end up having the bigger impact – and we cannot know what this will look like at the beginning. This does not justify non-intervention into the primary event itself, in this case Covid-19 and the attempts to stop the spread. We will never know what would have happened if we did not make serious attempts to control the spread of the disease, but we can hypothesise that as the health impact would have been exponentially more catastrophic, so would have been the secondary impacts and stress generated by the health impact.
It helps if the authorities can assure us of our safety by fixing any glitches with systems that are out of our control, like border control and quarantine procedures. Once we have confidence that these systems are working well, our minds can stop treating that as a potential threat to our safety and we are more likely to be able to return to our usual activities. We can get caught up in our daily lives again until the next time our attention is drawn to something that triggers our threat detection system.
It’s not good when it happens, but mistakes do occur. And unfortunately, these can have consequences that mean the world suddenly feels a lot more unpredictable and uncertain again. It’s important that we can be assured that mistakes are being addressed, and that we can get good information about the size and the nature of the actual risk. If these are not addressed, our threat-detecting brains keep racing to protect us against events as if they are life-threatening and this can provoke big emotional reactions.
When the virus resurges and lockdown strikes again, how do we go back to staying home to break the chain and save lives? Until we have better treatments and a safe and widely accessible vaccine, we will need to go through a phase of actively reminding ourselves of what we need to do when we act like we have the virus.
The risk of imposing restrictions in subsequent waves is that we can develop a sense of resignation, and that may take two forms: apathy and determination.
Part of this will depend on our earlier experiences of attempts to control the spread and impact of Covid-19. Having a sense of agency – the belief that we, or others who operate on our behalf in the institutions of government, can exert some control and influence over the spread of the virus – may mean that this feeling of resignation is partnered with a sense of determination. We may not like the situation we find ourselves in, but we will act in order to meet the challenge.
However, if our previous experiences were paired with a sense of helplessness and being cast aside and alone to deal with the threat ourselves, and that we were being governed and protected ineffectively, then this is more likely to be paired with a sense of apathy: no matter what we do, it will make no difference to the control of spread and impact of the coronavirus.
These are dangerous times, and to a certain extent, locked in through previous experiences.
Concerted action, consistently taken over a period of time by all, can start to change any apathetic view – but it will take time, and a large degree of support, and notable successes to make meaningful changes to this attitude once it starts to take root.
In New Zealand, and in many places around the world where good progress was made in limiting the speed and impact of the coronavirus, we learned that we can experience success, if not elimination. I think we learned that if we could make sure our basic needs were being met – that we had a reliable income and that we could get food – then we could actually get through this.
Along the way, one of the by-products was perhaps a realisation that people weren’t overly in love with the lives they were living pre-coronavirus anyway. As they went through lockdown, and if they were in a position to get their basic needs met, they then tried to make changes to take forwards with them into whatever life looked like after lockdown. Perhaps organisations learned that people working at home can still get stuff done. And perhaps people also learned that teaching your kids isn’t easy, and trying to do that and work at the same time is, at times, impossible. Teachers, you are the new heroes. Please take all the teacher-only training days you need.
One of the difficulties of lockdown is staying focused on the collective goal and avoiding stay-at-home fatigue. This occurs after a period of restriction, when we start to get cabin fever and feel tempted to break the rules, even if the virus hasn’t changed and the risk remains the same. During the initial lockdowns, one study following cellphone data showed that people started going out more frequently and travelling longer distances from home, after they passed that one-month mark of being confined to their home.
It has also been reported that the UK government discussed moving to a seven-day self-isolation period for those exhibiting Covid-19 symptoms – rather than the WHO recommendation of 14 days – because the evidence suggested people were more likely to stick to a seven-day isolation period (versus very low adherence to the 14-day policy). Governments have to deal with stay-at-home fatigue in a range of ways and these shifting sands make it even more difficult for people to understand what they need to do.
One simple explanation for stay-at-home fatigue that has been used by economists is called “diminishing marginal utility”. During the first few days in lockdown, you probably had the opportunity to do things in the house that you were fairly enthusiastic about. Maybe you binge-watched Netflix, or built a blanket fort with your kids. But after several weeks at home your kids are driving you nuts, you’re tired of trying to direct their learning, you’re into the dregs of Netflix shows and you just want it to stop.
In other words, you’ve used up all the “high utility” (i.e. high happiness) activities and are now scraping the bottom of the barrel. Cue stay-at-home fatigue, and the creeping desire to get out.
Many of us also appear to be driven by what it called “idleness aversion”. This may be a conditioned thing that we’ve grown to expect in life, but briefly, it’s our desire to get out of the house and do something, whether it’s a visit with friends or a trip to the burger place that’s more a craving than a necessity. Research shows that we don’t actually like sitting around and doing nothing for extended periods of time all that much. One study found that when subjects were told to sit in a room and do nothing, they chose to give themselves electric shocks rather than pass the time in silence.
So how can we motivate ourselves to stick to the rules? In conditions of uncertainty, or when we are not entirely sure how to act or what to think, we look to others for cues on what we should be doing. This is where we all need to act as leaders. To practise physical distancing, to wear a mask if we can. To wash our hands. To remain kind and courteous to others, even though this might be a big inconvenience in our lives. Remember that the goal is the return to some kind of normal living, bar the international travel, as soon as possible and this is only going to happen if we all play our part.
Unfortunately, looking to others can also play out in the opposite direction to our goals. The more we witness people breaking the rules and regulations with little perceived cost, the more likely it is that we will also be tempted to breach rules and regulations: If everyone else is doing it, why can’t I do it too?
Be realistic and intentional about what you need to do to play your part. Work hard on your wellbeing. We can still be civil, adopt the appropriate manners for our situation, and wait it out. It’s hard to remain physically distant, but it’s something we may need to maintain for a while longer.
We’ve done this before, so we know we can do it again. We’re also depending on each other to do the right thing and it’s only going to work if we do this together. But small actions by determined individuals can quickly add up to create a movement, and to signal to others through our actions that what we do matters and can make a difference.
Here’s how to strengthen your resolve and get through:
1. Reduce the overwhelm. You’ve done this before, you can do this again. Think about what worked for you last time and do more of that.
2. Make a public promise. If this fits with you, tell people what you are doing. When you go public with your intentions, it immediately strengthens your resolve, so announce it to friends and family on Facebook or by email. A public commitment shifts your own thinking about your seriousness. No one wants to be embarrassed in front of others.
3. Set up accountability partners. Recruit people like you to help you stay the course and build each other’s resolve. Create a system of accountability so that you can report your actions, successes and failures every day. This may be a friend or it could be on Facebook, or in a forum of some kind. Don’t just announce it once and then disappear; let the world know about your progress, and your successes.
4. Expect difficulties. There will be life situations that might get in the way of your efforts and it is so easy to allow them to undermine all your hard work. Think in advance of possible problems that might arise and decide how you will deal with these situations and how you can stick to the plan.
5. Think of the consequences. Another way to strengthen your resolve is to think of the consequences before you take an action that will lead to them. Not just for you, but for everyone and all the effort that’s been put in so far. Pondering consequences certainly isn’t a magic pill, but it can help if you usually don’t think about the consequences until they become real. Because that will most likely be too late.
6. Imagine others you respect can see you. Last but most definitely not least, you can benefit from some social pressure. Next time you want to choose the easy way out, imagine other people whose opinion you respect can see you. Would you still take that unnecessary trip if they could see you? And what would disapproval from them feel like to you? Yes, you’re essentially manipulating yourself, but if it works to strengthen your resolve to stick with a course of action that you value right now, then it’s certainly a tool you can go to.
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