“Talk to your fears”: strategies to manage stress during the COVID-19 pandemic

April 15, 2020

Wooden blocks with facial expressions

In this Joule COVID-19 Learning Series webinar, host Dr. Jillian Horton speaks to Jason Brooks, a performance psychologist, coach and consultant to physicians.

Given the pandemic could play out for months, Mr. Brooks says physicians need to implement personal strategies to deal with fatigue, stress and uncertainty, and offers advice on how to use feelings of fear to our advantage. 

tweetable: “I would not want to be in this COVID-19 situation and not have some degree of fear. Fear is an emotion that can keep you sharp, keep you safe and keep you from making mistakes.”

KEY TAKEAWAYS

You do a lot of work with physicians on how to deal with performance anxiety. How do you see that translating in the face of this crisis?

On any given day, physicians face the possibility of poor patient outcomes ― outcomes that can sometimes lead to death. The difference with COVID-19 is that a physician’s life may also be at risk, which adds a new layer of fear, stress and anxiety. Here are tips to cope:

  • Talk to your fears: It might sound crazy, but he says fear is part of our personality – our internal defense system. Jason suggests picturing your fear as an imaginary friend or family member and having a conversation with it. He says in order for fear to dissipate, it wants to know two things: that you hear it (and understand it’s there to protect you) and that there’s a reason for it to feel more at ease with the threat at hand.
  • Add certainty to an uncertain set of circumstances: Policies and procedures might be changing because of the pandemic, but the task of providing excellent medical care is the same. Focus on your medical expertise and your team’s energy and support. This will increase your confidence and the degree of safety at work.
  • Create a plan: If you’re worried about exposing your family to COVID-19, what’s the plan? Who will leave the home? Where would you go? When you start developing solutions to these questions, you reduce the anticipatory anxiety, and if the situation does arise, you can respond instead of reacting.

tweetable: “Don’t allow the ‘what-if’ fears to dominate. Work the ‘what-ifs’ into a resolution.”

You use mental rehearsal to help physicians cope with fear. What would that look like in the context of the pandemic?

  • The goal of mental rehearsal is to train the mind to respond in a particular way.
  • A valuable mental rehearsal could be to repeatedly practise putting on and taking off personal protective equipment.
  • In playing out the scene in your mind, he suggests physicians imagine themselves in a chaotic situation. Get a sense of what you’d be exposed to and what the distractions might be ― because those are what could cause a moment’s error in how you put on or take off the equipment.
  • He then suggests visualizing yourself slowing down, putting on the equipment and securing it properly. See yourself doing the same in reverse at the end of your shift.

tweetable: “The exercise creates the valuable mental repetition that’s going to strengthen that neuro-pathway, to cue my mind to do the thing I need to do to stay safe and be effective.”

You see transitions as moments throughout the day where people can pause and create intentional change. How can we use these transitions to help us manage stress around COVID-19?

Jason identified three types of daily transitions:

  • Transitions within your workday: These can happen hundreds of times during your shift. They are moments of self-reflection and mindfulness, when you can ask yourself: How am I feeling? Am I distracted or anxious? Do I need a mental break? Taking that pause can reduce your stress, so you have more bandwidth for the task at hand.
  • Transition from work to home: The commute home is a great opportunity to process the day. Talk to your family about how they can support your transition mentally and emotionally. Do you want to vent about your day, or be left alone for 15 minutes? Having those conversations can help your long-term recovery.
  • Transition from home to work: Get ahead of the anxious thoughts. Imprint to your subconscious: What do I want to feel today? What do I need to bring that would be helpful to my team? What am I scared of? And can I do something with those feelings right now?

tweetable: “We’re much better at starting the day with better focus and better energy when we have a plan. It’s like a mental warm-up.”

Can you talk about behavioural contagion, and how it can lift us up or bring us down?

  • Behavioural contagion is a person’s tendency to copy the behavior of others.
  • In the context of the pandemic, Jason says it’s important that physicians make a conscious effort to bring a positive attitude to their workplace and practise empathy, understanding and civility.
  • That kind of behavior is uplifting and will help people sustain their energy over a longer period.
  • The opposite is also true. If you bring negativity, fear and panic to work, those are the behaviours that will be contagious.

tweetable: “If ever there’s been a time in the history of being a medical professional where collegiality, encouragement, civility and overcommunication are absolutely essential, this is the time.”

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This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule.  Feel passionate about this topic? Please connect with us at jouleinquiries@cma.ca.

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