Taming a Beast

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COVID.

Even the phrase has an ugly ring to it. Sounds like the name of a real mean dog or maybe a hideous reptile. Nothing against dogs or reptiles, but...

All of us have endured and are continuing to endure various hardships as we cope through this very perplexing and often heartbreaking time. This pandemic has imposed great life restrictions, illness and even death. Besides a physical mask, many of us also “mask” our fear, resentment, frustration, opinions, and personal pain over COVID with a smile. Imagine what it is like having a mental health condition while trying to cope through COVID!

I work at Birch Tree Center, a mental health stabilization unit in Duluth, MN. I can tell you that COVID has hit people who have mental health problems very, very hard. The stigma, the fear, the isolation, the grief, the uncertainty, the interruption and suspension of needed services, and the loss of control and autonomy over one's life has contributed more to the provocation of mental health crises than practically anything else I have ever seen (other than alcohol, marijuana and illicit drug use, which so many people have turned to for solace).

One can debate the issues surrounding this pandemic. However, our job, whether at a crisis center, an AFC, SUD, or an IRTS, is to help the people we serve to find comfort, empowerment, and the courage and motivation to get through their issues, whether COVID-related or not.

One of the central issues surrounding COVID is worry. Worry is like a beast churning in a person's heart and mind, gnawing at the fibers of sanity and happiness, interfering with relationships, health, and activities of daily living. It's like an infection.

In order to assist a person in overcoming worry, I find the following technique/thought process very helpful, as it can be a component to the topics of anxiety, challenging negative/intrusive thoughts, and radical acceptance. To illustrate this concept/technique, I ask the person to write down the word "worry." Then I ask them to circle the word and write down, around the word, what comes to mind when they read the word, regardless of what the worry is.

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Many people write down several words and phrases, among them: helpless, defeated, beaten, torn, feeling sick, feeling dizzy, anxious, depressed, light-headed, spinning, pointless, nausea...many others. I have even heard the word "violated", as worry is often part of a cycle of rumination and intrusive thoughts. The responses/reactions they seem to identify most often are "endless misery/suffering," "hopelessness" and "loss of control."

I then suggest that the person change the word "worry" into "concern." I ask them to complete this sentence: "I am WORRIED about _____."

Then I ask them to put the worry they identified at the end of this sentence: "I am CONCERNED about _____."

The power of a single word! It is often a great relief to delegate a "worry" to a "concern". More often than not, this conversation helps the person to realize how they can honestly and realistically master how they have been thinking about the situation, which in turn helps to change their attitude and perspective on it. To my experience, this has proven helpful as a first step.

The next question: Now that you have identified the worry, called it out on paper so it's not just haplessly spinning round and round in your mind, how can you resolve it or cope through it successfully?

This allows the person to take an active role over taming the “worry beast” by coming up with their own solutions. It also opens up dialogue and sets the stage for the person working with them to offer necessary referrals (such as therapy, psychiatry, primary care, community resources) and coping skills to assist them in resolving the problem they were able to PERSONALLY identify. There have even been times when the person has been able to identify that the worry they were focused on is a by-product- a mask of sorts- for the actual source of the worry. This realization essentially "hands the reins" back to them so they can gain control over that worry beast, using that energy to begin working towards their own personal success.

At the end of one such conversation, a guest I was working with asked for a separate sheet of paper, wrote down the word "WORRY" in big letters, circled and put an "X" over it, then wrote and underlined the word "CONCERN". "I think I will go to the activity room and dress this up a little bit. I am putting this on my refrigerator when I get back to my apartment," he said. "It will help me with my anxiety, and I will remember this talk." He gave me a smile that warmed my heart.

The people I am privileged to serve have come up with all sorts of great coping strategies to better control worry before it dominates their thinking, intensifies negative emotions and grows into full-blown anxiety/illicit drug use/depression/suicidal ideation. Among them are practicing self-care, gratitude, using mindfulness, being aware of and having a plan to cope with the issue(s), distraction with positive things such as music, engaging in exercise, identifying where and how to take personal accountability and responsibility, identifying when it's time to reach out for help, empathy, and realizing they are not alone.

I would hazard a guess that these suggestions could apply to dealing with COVID as well!

This is what is behind the "mask” of anxiety. It's not always that mean dog, that hideous reptile, or some kind of infection, be it mental or physical. I can't help to sometimes think, "Worry, thy name is COVID." We need to be ever mindful that behind the symptoms- the mask- is a fellow human, susceptible to the trials and tribulations of life, longing to belong and experience its joys. The experience of being human, despite all its foibles, bumblings, WORRIES, inconveniences and differences is a condition of humanity. The experience is lived from the unique perspectives of all who share it. How we live and help each other through this human condition will dictate how we survive and thrive, regardless of what it contains.

Let me concern myself with that!