Surviving a Pandemic: Tools for Addressing Isolation, Anxiety, and Grief

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A selection of exercises, rituals, and ways of preparing you can use to reconnect with your agency and ground yourself as we face the long-term effects of the COVID-19 pandemic.

The following text draws from our lived experiences of struggle, of growth and of loss. It is informed by the things we have learned from the practice of Somatic Experiencing as well as through doing end-of-life care as death doulas, as nurses, and as human beings loving people in a hard world. This writing also springs from seeing the need for us to acknowledge and face our fears on an individual level in order to ensure that we can build the capacity to trust each other in this new uncertain context. No one knows how to contain this pandemic—and it is more evident than ever that we cannot trust the state. Tending to our mental health can increase our capability to act together.


We find ourselves in a new era in which we must figure out together how to navigate life in the midst of a worldwide pandemic. All of us are experiencing collective trauma as the wave of COVID-19 moves across the world, tearing apart the basic fabric of society. Other living things sigh a deep breath as capitalism falters in this country. This historical moment has opened up the opportunity for new pathways towards connection and mutual aid in both social and economic aspects of our daily lives as we continue to experience the weirdness of physical distancing and the ambiguous loss of what we have known as day-to-day life.

It is a worldwide collective human experience to be moving in and out of moments of stress and uncertainty as we try to navigate life with this virus. At the same time, this pandemic is not a unique event; it is part of the new normal in this global economy. Viruses will continue to spread as long as we go on upsetting the ecological balance of the planet. Yet what we have been through so far could help us to figure out how to build more of the society we want together as we move into the future. While this may feel difficult, it’s important to remember that we do have agency—together, we can build a meaningful life in the rubble of the parts that we must leave behind.

This text is a small effort to help hold each other up in the process of this collective readjustment as we continue to fight in pursuit of the dreams we have for the world. We offer a look at the importance of moving through the many aspects of grief with some suggestions as to how we can prepare for the unknown ahead. We provide several somatic exercises aimed at facilitating our ability to ground ourselves in uncertain futures while also finding creative ways to get connection and expand the imagination in spite of the need for increased physical distancing.

Some of us are in shock. Some of us are anxious. Whatever feelings and mental states you are moving through right now, you make sense. Each of us, in our own way, is undergoing what is known as ambiguous loss. The collective experience of COVID-19 began without any sort of closure for our pre-pandemic lives. None of us have a clear understanding of what this means for our day-to-day life. We don’t know how we will make money in the future. Unplanned loss can overwhelm our coping abilities, making normal functioning extremely difficult. We have to figure out new ways to structure our lives. This can leave us anxious and complicate or delay our process of moving through the loss in order to adapt to the changes. In addition, many of us are also experiencing the anticipatory grief of the impending loss of loved ones because of the pandemic. None of us are alone in this.

Because of the way our threat response cycle works as humans, we are having a hard time orienting to what the threat is because the future is so unknown to us right now. We are hyper-focused on our phones and screens, seeking both information and connection to help settle us—to help us obtain a sense of control and imagine a path forward. Yet this does not calm our nervous systems. Our brainstem is designed to locate a threat, usually scanning far out into the distance before moving up close to our present surroundings. In this situation, our nervous systems tend to remain in a heightened state because our present environment is giving us the potential of dangerous information and swiftly changing news.

Our immune systems are deeply interconnected with our nervous systems, and our stress levels impact both of these. In particular, extended periods of shutdown strain our immune function. We hope that some of these tools can help move you towards settling your nervous system, as well as towards the mobilization many of us seek.

Social isolation is a risk factor, compromising our mental and physical health. In this new context, it is very important that we direct intention towards connecting with other people. Using screens and video chats can cause an extreme strain on our attachment system. We must make an effort to nudge ourselves towards facial expression, making eye contact and modulating our tones of voice with others. We must imagine windows where there are walls. It is important that each of us resist the tendency to normalize the fear of others, which we already experience so much in this individualized society. Implementing these practices can help us avoid fear-based interactions with friends and strangers alike.

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Consent

One way that we can reduce stress and harm to ourselves and each other is to practice good consent when interacting with others. For example, take the time to figure out what you want your personal boundaries to be when you interact with others. Do you need to be six feet or more away from people? Do you need them to be wearing masks if they want to talk to you? Do you feel comfortable sitting next to someone? Is touching toes acceptable? If so, under what conditions?

Ask yourself questions like these and make your feelings known to others. This will help to prevent people from accidentally crossing a boundary that they weren’t aware that you had. It can also help to reduce the kind of self-policing that can happen when people feel scared and uncertain, enabling everyone involved to be able to trust that everyone around them is being thoughtful about their boundaries and needs.


Exercise: Self-Hug with a “Vu” Sound

Self-touch is a useful tool, especially right now when we are getting less physical contact. Stress and shutdown responses can affect our digestion. Making a low “vu” sound encourages our nervous system to downshift towards a more balanced state, bringing a sense of cohesion to our organs and body. This particular sound comes from the lower trunk part of our body. When we focus our attention on feeling the sound as it comes from below our diaphragm, it helps us to reset.

There is a great deal of difference between a forced breath and one that arises spontaneously. Instead of taking an intentional deep breath, allow yourself to make a full exhale, and as you do so, notice the quality of settling as your body comes into balance.

Try to pay attention throughout your day to notice when you let out a deep breath, a sigh. This slow, audible exhalation is an everyday experience of resetting the body and mind. We spontaneously sigh many times an hour as our nervous system resets and regulates.

Place your right hand under your left armpit, close to your heart. Then place your left hand on your right shoulder. Notice the warmth of your body. Invoke a sense of containment. Pay attention to see if you feel any sort of ease settle in your chest, or if you get a spontaneous deeper breath or a natural breath that comes back in. Then, when you’re ready, slowly inhale and, when you exhale, let all your air out slowly with a “vu” sound, like that of a low foghorn. Repeat this three times slowly. Imagine your brain moving down into your pelvis, like an ice cube melting, flowing down to help regulate your nervous system. And finally, just be curious about what you notice. Has anything shifted? Is your attention more available?

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Exercise: Extending Your Gaze

In our modern situation, and especially with the sudden need to care for each other with physical distancing, we spend a lot of time in focal vision, in which we move focused attention from one object to the next. It is helpful to extend our peripheral awareness and gain a greater sense of physical perspective as we adjust to the context we each find ourselves in. Staring at screens, or even at printed material, is a fairly recent human invention. Before industrialization, the vast majority of people did not spend so much time looking at things so close up. We evolved in the savannah. Human evolution brought us out of the trees to stand upright. It’s good for our system to be able to see over long distances, even in the cityscape. Focusing on the point of furthest contact gives us a more softened and expansive consciousness, while still maintaining a sense of awareness. The goal is to enter a state of relaxed alertness in which you are able to access a wide range of responsiveness in any given moment.

To begin, let your eyes go where they want to go. Allow your eyes to wander slowly. Take a moment or two to do this; be curious about what you notice. Then, begin to look for the thing you can see that is the furthest away. It might take a little effort to adjust to looking in the distance, but take a moment to play with that. What’s the furthest thing that you can see right now? As you find that object, notice how your eyes soften, how the muscles in your face relax. You may notice that you naturally inhale or exhale more deeply.

Next, slowly extend your arms out in front of you and move them outward to the edges of what is just within your peripheral view. Once you have found that spot, turn your palms in and slowly wiggle your fingers. As you again find that object at the point farthest away from you, notice your eyes soften. Allow your eyes to rest and tap into a deeper sense of centering. Notice how you can hold relaxed vision and pay attention to the movement of your fingers at the same time. In this place, you are in balance with a relaxed alertness, ready to respond to threat from an underlying state of calm.

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Exercise: Face Attention

It’s important to make space to express feelings of agitation, rage, and grief. The goal of this exercise is to legitimize and tend to these feelings, giving them permission and expressive release. When we engage our facial muscles, it helps to downshift and regulate our nervous systems. This enables us to communicate better and read others’ faces better too.

Begin by directing your attention to your face. Slowly scrunch up the muscles in your face until they are as tight as possible. Hold this for a moment, then release the muscles. After a few natural breath cycles, move to widen and extend your face outward. Open your mouth and stretch your cheeks. Hold this for a moment and then rest. Move back and forth between these states several times.

Then, when you are ready, focus on any feelings that want attention and movement. Begin again to scrunch up your face, bringing awareness to your eyes and nose; scrunch harder, letting the anger know that it’s OK for it to be there. You may experience a spontaneous settling breath. Next, use your eyes to direct a piercing glare. Grit your teeth slightly. Allow any sort of rumble or sound you feel within you to make its way out of your mouth. When you are ready, let your face to return to a neutral state, allowing your eyes to soften. Repeat a couple times, if needed.


Exercise: Progressive Balancing

Our bodies can get stuck in habitual patterns in which some areas are extra tight or tense, while other areas can become absent from our awareness altogether. In order to shift these states, we have to become aware of them. An excellent way to do this is to create and release tension intentionally. This exercise brings attention to what your nerves are usually doing unconsciously, enabling you to begin to shift those patterns.

From a standing position, with your eyes closed if that’s comfortable for you, begin to tense up one area of your body, then another, allowing yourself to breathe. For each part of your body, count slowly to eight while you hold the tension forcefully. Then slowly release the tension as you exhale, imagining that that part of your body is expanding or taking up more space, as if all of the cells that comprise it are growing. After the next breath in, exhale for a count of eight, imagining that that part of your body is relaxing—melting like butter. Go through the process of tensing and relaxing each area twice. Be sure to allow for a few natural breath cycles between the two states.

Start by tensing your neck and throat. Many of us hold tension in our necks, sometimes keeping rigid as a consequence of trying to control situations. The neck is a great place to gain back some ease. After doing this twice, rest a moment. Second, tense your shoulders, arms, and hands, as if you are getting ready to fight. Notice your muscles and any sensations of strength in your body now. Feeling your arms can give you a sense of how much space you can take up. Third, tense your stomach muscles. Many people feel a tense knot in their upper bellies connected to anxiety, while others feel an emptiness or lack there. Focusing on sensing your belly can be a step towards restoring a depth of experience and a sense of quiet at just being. Finally, tense your legs and feet. Lots of us feel separated from our legs; restoring your awareness of them can be a step towards feeling your strength, standing your ground, and rediscovering your power to charge or flee if need be.

After all this tensing and relaxing, do an extra swinging movement to discharge any excess tension. Stand and turn your upper body from one side to the other, as if you’re looking first over your right shoulder, then over your left, gently rotating your whole upper body in the process. Let your arms hang loosely, following the movement, so they swing out in front of you, then knock gently at your sides at the end of each twist. You can relax your knees a little, letting your hips join the turning movement. Feel the gentle twist of your spine as you move. Do this for a minute or two.


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Preparing for Every Possibility

This pandemic reminds us that we are never quite sure what is going to happen. As we confront uncertainty, it can help to give us a sense of our agency to address all the things that we can control. Even if these preparations do not become necessary for years or decades, you may feel more grounded having made them.

Dealing with Loss

The ways that the pandemic and social distancing have destabilized our lives have already given rise to a painful sense of loss for many of us. Whether you are dealing with the changes in your life or mourning the passing of a loved one, it can help to use ritual to structure your relationship to these feelings.

Here are some ideas for creating ritual around loss:

  • Light and burn candles at a planned time.
  • Read poems aloud. Record them to send to each other.
  • Host bonfires and share stories. You can still do this while maintaining a safe distance and wearing masks.
  • Choose objects with which to create an altar for remembrance or transition, so that people can gather and witness together.
  • Develop a memorial ritual honoring your loved one, like picking a bouquet of flowers, to observe on special days or whenever you wish.

You can also practice ritual on an individual level. This can help give you a feeling of control over your environment at times when that is otherwise hard to maintain. It can help you feel more grounded to focus on controlling things that only affect you, such as the structure of your day, the order in which you do certain things, or the arrangement of your things in a personal space, for example.

Many of us are experiencing a dramatic increase in the amount of time we spend at home with our loved ones. This makes it especially important not to take out our difficult feelings on them. Giving ourselves creative and intentional ways to deal with our need for control, such as focusing on ritual, can help keep us from hurting or conflicting with those around us.

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Tools for End of Life Care

One of the best gifts we can give to each other is to prioritize having the difficult conversations necessary to prepare for the unknown. We encourage you to talk with your friends and family about what you would want in case of serious illness. This is a way to increase your self-determination and autonomy even in a worst-case scenario. Write down what you will want your companions to do if you are sick or dying and what you want them to do after your death. Here, we offer some of the logistical aspects of how to do so. Be as specific as you feel you can. It can be an immense relief for friends and family not to have to make such significant decisions for you in a situation in which you cannot make them for yourself. Preparing in this way forestalls the sort of second-guessing that can occur even among those who know your desires best. You are never too young or too old to take these steps.

Giving thought to this can be an important way to prepare for the unknown and to care for ourselves, as well as those we love.

What Is an Advance Directive/Living Will?

An advance directive, also known as a living will, is a state-specific legal document that declares your healthcare wishes should you become unable to make those decisions for yourself. It can describe what kinds of medical intervention you do or do not want—for example, CPR, artificial nutrition and hydration, intubation, or surgery. While the forms vary state to state, you can obtain them online or from your doctor, if you have one. This document can be revoked at any time as long as you are cognitively able to do so; it must be notarized to be considered applicable. The form requires you to name someone as your health care agent/health care power of attorney.

What is a HealthCare Power of Attorney (HCPOA)?

A HealthCare Power of Attorney is a person you select to make all your healthcare decisions when you cannot do so for yourself. You should share as many details with this person as you can about what you want for your care. You can set up secondary and tertiary agents in addition to a primary person. If you want them to make decisions collectively and horizontally, make this clear; legally speaking, your primary will have all of the decision-making power unless you specify otherwise. Make sure that you get consent before selecting someone for this role, as it can be a significant responsibility to give someone who may not feel comfortable making such high-stakes decisions.

Some questions to ask yourself when considering a HCPOA:

Can this person do the job that I am asking them to do? Are they the type of person who can or would advocate for me? How comfortable are they making emotional decisions under stress? How likely are they to answer the phone in an emergency situation? Do they live close by? Are they able to travel to reach me? How well does this person know me? Have I asked them if they’d be willing to do this for me?

Some general questions to ask yourself when considering the uncertainty of the future:

  • What are the things that you feel regretful about that you could resolve today or in the short term?
  • Are there letters that you want to write? Things that you want to apologize for?
  • Write down three experiences you want to start working towards now. Who would you like to have with you?
  • Are there any belongings that you want to make sure a certain person gets when you are gone? Is there anything you want to get rid of today?
  • What should your funeral sound, taste, smell, look, and feel like?
  • If you could do anything with your body when you die, what would it be?
  • Are there life-extension interventions you do not want used to keep you alive? What if you are still conscious and able to communicate?

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In the uncertainty of this moment, please know that you are not alone. You are part of a larger fabric of human collectivity that spans time and space, stretching beyond the confines of capital and state control, even beyond the reach of viruses. Whatever you may be facing, remember that those of us that dream of a wholly new world are in this together. Take care of yourselves. There is still so much possibility we can enact.