Since SARS visited Hong Kong in 2003, the world has had warning visits of Ebola, Swine Flu, Avian Flu and MERS-CoV.  Now, the pandemic of COVID-19 is upon us. We have been watching it grow rapidly in China and aboard the Diamond Princess cruise ship. It has spread rapidly in Italy, Spain, South Korea, and is now severely threatening the US, Canada, and many other countries.  Political leaders around the globe have reacted with varying degrees of alertness. We have witnessed country dependent degrees of control over its spread and growth.

As individuals, how do we handle the fear and anxiety we face with this viral threat? The question of dealing with fear and anxiety is one that is always present for those with DID. But now, we need to understand that just as individual trauma is processed individually, it can also happen in a society or, as now, sometimes on a global scale.
In general, fear has a protective function.. Within the context of DID, fear about survival triggers the dissociative experience in a young child. Epidemiologists are characterizing this virus as a survival issue for many people, economists are characterizing it as a survival issue for commerce.

It is fear that is motivating us as a society to adopt drastic measures such as school and factory closures, the cancellation of public gatherings, cruise ship trips, unnecessary vacation flights, and even restaurant dining. These measures will curb the growth and spread of the viral infection. This is an example of vigilance heightened appropriate to the threat.

What is left is handling panic or the excessive fear. This not unfamiliar to those accustomed to working with trauma and PTSD.  One point that is emphasized in the Engaging Multiple Personality series is the need to slowly transform hair-trigger hyper-vigilance into ordinary protective vigilance. I always point out that we must maintain vigilance, not eliminate it. Why? Because there are dangers in the world and we need to remain alert.

However, the opposite of hyper-vigilance is also on display in this pandemic. There are countries where leader(s) have ignored science and discouraged vigilance (hyper or otherwise) against all apparent facts. We see news reports of some young people in particular that are affirmatively ignoring and denying the social distancing recommendations. They put themselves at risk because they do not believe it is a danger for them that outweighs their need to some immediate gratification – like Spring Break.

So let’s stay appropriately vigilant. In that light, I would like to focus on the following points as a guideline in facing this Corona virus Crisis.

[1]   Be informed of what you fear.  For most people, COVID-19 infection presents from an asymptomatic state to mild symptoms similar to a cold or flu.  Some complain of a dry cough, abdominal discomfort, and breathing difficulty.   Only a small percentage of those infected may need special care in a hospital setting; for intubation, oxygen in “equipped beds” and so forth.

[2]  You have a responsibility of protecting others if you are sick. If you suspect you have COVID-19, don’t go to your doctor and potentially infected everyone in the waiting room. Instead, call the hospital for help and let them know you may have the viral infection. Note that several sitting US Senators self-isolated immediately upon suspicion of the virus while one who is actually a doctor was tested because of his high personal risk exposure. He continued to interact with colleagues for days without telling them he was a potential asymptomatic carrier. He was indeed infected. Again, an example of an inappropriate lack of vigilance putting a wide circle of people at risk.

[3]  Frequent hand washing is most important as well as avoiding touching door knobs and door handles with your uncovered hand.  Wear disposable gloves or have a tissue/napkin to cover your hand when touching one of those surfaces. Wear face masks if you feel any symptom and avoid touching your own face as a general rule. In person, keep social distancing. Better yet, maintain physical isolation if possible but make sure to connect socially through the phone and/or internet so as to avoid emotional isolation.

[4] Having put 1-3 into practice, pay attention the psychological aspect of coping with the stress. Do grounding exercises throughout the day. Preferably start the exercises before you panic so that when anxiety erupts you are already habituated to grounding yourself. It is a good practice to do them when you get up in the morning, perhaps once mid-day, and before going to sleep at night.

The following is my very personal view of the pandemic, so please take it with as many grains of salt as you think appropriate…

In the 14th Century, the plague killed one third of the population of Europe.  Despite subsequent medical advances, the plague has recurred many times since then. The last time that I am aware of was in October 2017 when it hit Madagascar and killed 170 people. Ebola had been hitting certain African states regularly. In modern times, we have had repeated corona virus infections of different varieties that we have hardly any means of control.

These epidemics regularly hit different parts of the world. We generally don’t hear about them because we (and our local media) tend to ignore them when they do not impact us directly. We usually have other bad news to worry about, such as fighting in Afghanistan, Iraq, Syria, Yemen and elsewhere.

I do not blame God or any extra-natural sources. It doesn’t seem helpful to me. As humans, we must learn to survive in an increasing complicated world. This has been the story of humanity throughout our history. A key to what is helpful is learning to appreciate that we are all interdependent. We have a long way to go to reach a world of peace and accord. Perhaps we can use this as an opportunity to move further toward that goal.

Life comes with needing to accept the fact there are periods of adversity and to work with them. For some experiences of adversity, we can learn to face them with insight, compassion for ourselves and others, and eventually with some equanimity. Indeed, it is time for us to rethink our place in the world and the universe. This is an opportunity for each of us, certainly for me, to question why are we here, what is our purpose today.

It goes back to the question I faced when beginning my retirement, what is the reason for me to get up in the morning? The answer began to dawn when going through my patient files as part of closing up my psychiatric practice. It seemed that my DID patients had gone through such profound trauma and taught me so much. It was difficult to be retired, unable to help any more. I began to try to organize my thoughts, which resulted in the Engaging Multiple Personality Series and blog posts.

I believe these writings have been helpful to many people, at least as indicated by emails and Facebook comments I have received from those with DID and their spouses/partners as well as sometimes psychiatrists and other therapists. In this way, the DID community has helped me process the vicarious trauma I experienced listening and trying to assist my patients. It continues to heal my heart.

I offer a quotation from Rabindranath Tagore which I have found inspiring:

“I slept and dreamt that life was joy. I awoke and saw that life was service. I acted and behold, service was joy.”

In my retirement, and in this COVID-19 crisis, I am seeking to make contact with some people I know who might benefit from a warm phone call, one that might penetrate their loneliness and isolation. I read books that I have always wanted to read but never before had time. I listen to music that nourishes me. I try keep my body active and supple, to prevent waking up with pain all over my stiff body. I also do my one-breath-meditation and walking meditation. This is the least I can do to be kind to myself. I also write my blog articles when the circumstances and spirit moves me.

With best wishes for your healing and strength.