My Personal Experience with COVID
Third Installment of the mental health effects of COVID
It has been nearly three years (or since about March 15, 2019) when I first heard the word COVID. It’s probably easy to recall when you first learned that a world-wide pandemic was pushing its way forward towards the United States from China.
I was at a conference in Washington DC, and I was reading about it on second-page news. I remember thinking to myself, “hmm,...this looks like it could be a front-page issue.” My life changed directly as the news started moving fast and frantic especially when COVID made its full presence known in the USA, in of all places, the State of Washington.
Since then, I, too, feared contracting it, and for this reason, I tried to live a COVID-free life, which has been, now, three years in duration. A life of isolation and carefulness.
As of August 16, 2022, I am no longer in that rarefied group who, through substantial personal discipline, excellent luck, or who happen to live in such isolated areas like Hurricane, Utah, that for a long while COVID was not a threat to them, or perhaps to be blessed by God-Almighty with superb genetic resistance to viruses in general. So, act how they will, they never get anything like this.
As I write this apologist’s entry, I am physically sick with the typical symptoms: fatigue, headaches, a tightly congested chest, burning eyes, chills, and so on. I’m not laying flat in bed because I can’t, or I’ll suffocate in a prone position. I’m frustrated with myself all through it, but probably more angry with the larger circumstances surrounding a virus that no one can do much about. To all the clients I see or have seen, I will recover. My COVID-19 contraction was not fatal. But, my course on COVID is a textbook for a high-risk 66-year-old. Yes, with the likelihood of long-term COVID-19 in my future, given my various frailties and other high-risk conditions. Some of these I’ve had little say about, like cancer, but others, like high blood pressure and cholesterol, I could have done better early on to prevent progression, perhaps.
I share my COVID-19 story. How I became aware I was at risk, what I did about it, and how it turned out for me. As I do, it may sound familiar to those who have contracted one of the COVID variants.
I provide, first, some background about my view on what kinds of mental health issues we are experiencing and will still be facing as we remain a COVID-positive world.
Is the COVID Situation Getting Better of Worse?
That is a good question. As I perceive it as a psychologist it’s hard to say; however, people want to be done with COVID.
One of the best avoidance strategies humans employ to eliminate anxiety around anything they fear is the defense mechanism of Denial.
What is denial?
Google defines Denial this way: “Denial is the conscious refusal to perceive that painful facts exist. In denying latent feelings of homosexuality or hostility, or mental defects in one's child, an individual can escape intolerable thoughts, feelings, or events.”
I’m disappointed with this definition for many reasons, but I start here because everyone, including me, reads Google - for efficiency, focus on the specific phrase: “latent feelings” …to do this the individual, somehow, just doesn’t see obvious things, doesn’t even recognize they exist when it’s crystal clear by physical signs that they do exist. This means the “denying” person somehow intra-personally turns off or escapes the intolerability of coming to terms with objectionable thoughts, feelings, or events that would otherwise be perceived as shattering to the person’s sense of sanity in themselves and their world.
I’ve seen this in extreme forms in clients. Sometimes, when a person is in abject denial, say that a loved one has died or been killed, they initially show almost no emotion, they act like the person will be back, or they are even right here in the session with us. It is both surreal and disturbing. But, strangely, it is an understandable human mechanism that our psyche employs at times to cope with extreme trauma to the self.
A more psychoanalytically robust definition of Denial is a Defense Mechanism: “A group of mental processes that enables the mind to reach compromise solutions to conflicts that it is unable to resolve. The process is usually unconscious, and the compromise generally involves concealing from oneself internal drives or feelings that threaten to lower self-esteem or provoke anxiety. The concept derives from the psychoanalytic hypothesis that forces in the mind oppose and battle against each other.”
In this sense, Denial is one of several kinds of processes (e.g., repression, reaction formation, etc.) that early scholars of this theory of psychology observed and then labeled as occurring when interacting with people encountering anxious stimuli. Defense mechanisms are designed to protect the internal self from the threat of non-existence or trauma, and of these, denial is the most clear-cut.
The threat is eliminated if it simply does not exist. I have seen more normative forms of denial. One area that most people will relate to is the break-up of an intense romantic relationship. If a person is fragile enough, a prospective partner might break up with that person, but the lost lover still believes the relationship is continuing. “Perhaps, my former partner is just angry and wants to be alone for a while.” This is a more normative form of denial to cope with the interpersonal threat that the relationship is over. If a breakup is a threat, the person just magically eliminates the “break-up.” Anxiety gone. Right!
I’ve also seen, many times, where the “failure” of denial causes substantial emotional pain in its own right, such as those clients plagued with the crystal clear awareness that everyone, in a relatively short period of less than a hundred years, will no longer exist on this earth. There is no way to stop it.
Ernest Becker, a well-known social anthropologist, wrote an entire series on this point, “Denial of Death.”
When people are in denial they can do very strange and seemingly stupid things. Applying it to COVID, sure, it’s been far too long to tolerate a threat like this. It scares me and I’m tired of being scared. I resent this disease, or so the analogy goes, and tension mounts within the mind to “DO SOMETHING TO STOP THIS INCESSANT ANXIOUS STATE.” Soon, it is clear that nothing objective can be done…This opens the door for denial.
The following article appeared in JAMA (Journal of the American Medical Association), the gold standard for information on medicine in the 21st Century. Dated May 27, 2022, entitled: COVID-19 in 2022—The Beginning of the End or the End of the Beginning?
“Now in the third year of the coronavirus pandemic, well after the Omicron variant surge, both in the US and globally the number of daily cases had been declining to their lowest levels in more than 6 months. While it seemed that SARS-CoV-2 was moving toward endemicity, US infections are again rising in May 2022, and the reported number of cases is likely a gross underestimate of actual infections because many infections are unreported with increasing at-home testing…The authors note that there are two reasons for this. 1. The emergence of Variants, and 2. the limited durability of protection from infection.
What are they saying? 1. COVID 19 has outmaneuvered our current best efforts to stop it or keep it at bay.
The article goes on: Given the fact that many places are no longer requiring masking, people who wish to mask are left wondering what to do and if 1-way masking (wearing a mask while the surrounding individuals are not masked) provides any protection. The data suggest that 1-way masking is still effective but that for maximum protection the person should wear a high-quality and well-fitting mask such as an N95….
I’m not saying here that we should all go back to wearing masks. They were a hassle and a half. Right! But, when we were scared some years back (scared=fear=anxiety) we took this advice. But, we are not scared anymore. Why? DENIAL.
Again, I’m not saying this is good or bad to be in a psychological state of denial. Recall from my previous entries in this blog, I’m not in favor of labeling almost anything as solely good or bad. But, What I am pointing out is that on a societal level we have now armed the collective human consciousness with an intra-psychic capacity. “Multiple Minds” = “One Mind”. As a social collective we are now creating a broad collective strategy to protect us from fear of threat of the virus. What I’m referring to here is mass denial.
It’s similar to how people, in general, deny the literalness of death. All people deny the reality of dying, because when this breaks down we panic. Individuals, groups, collectives do not like panic. The experience is too disruptive for normal functioning. In its own way, panic is destructive. So, alternatively, denial enters the picture. Denial, in some instances, is adaptive.
Question: Is it adaptive to deny that COVID exists?
My Story of COVID
Last week, August 12, my son Justin who lives in our home mentioned that thought he might be getting COVID. I was just finishing cases downstairs, so I’d been in the house all day when my spouse, Debra, told me the news, I packed quickly and within an hour I was staying in a hotel, downtown, just to be safe. A nice hotel because I’m thinking, “if Justin is infectious, it seems I always get it from him. Perhaps a genetic link or something.”
I thought I might have escaped it, because I’d been down in my office with the door closed and I hadn’t seen him all day. I was feeling good, not great, but good. Either way, as a precaution, from my office downtown, I started cancelling all in-person clients, and watching symptoms progress from home, Justin kept getting worse. He was tested and positive for COVID, Debra had same symptom patterns. I knew I was probably in trouble when I started getting this tiny scratching throat. At that point, I started cancelling all 30 clients for the week and not re-scheduling anybody. I was still feeling OK, not good, but OK. Started working at office with no one there. Sleeping OK at hotel. This went on for 3 nights 4-days. I was NOT in denial.
Then, I started to get sick, real sick, sore throat, raspy breath, powerful headache. Had several emergency clients, but everything was phone or televideo.
Checked out of hotel, Aug, Mon 8-15 went home, getting sicker, wearing mask everywhere. Got home, started working on art. made some progress. Felt better, then I tried to go to sleep, couldn't sleep because of wheezing, wheezing turned too constricted, I thought, Damn, I'm in big trouble now, I had a past hx of asthma, but no current meds available. I had to do something, so I started breathing steam from the shower. managed to lower my panic, barely breathing, sat up in chair all night, did not sleep. Next morning or 8-16, I was feeling like I'd been hit by a truck in the chest, was in very big trouble, like my airways were just barely open. I'm also thinking, "I know how it got in here, Why wasn't Justin more careful?" Discarded the thought, useless, I think I’m getting angry because I’m delirious, thrashing around in anger. My chest is hurting, like some kind of weight on it, can't move my lungs in and out. I'm thinking, "If this is a heart attack, and I'm not dead, I'm likely headed that way." So had Debra call the U of U walk in clinic, I could make it there, I thought. She was still sick, so she couldn’t take me, not a good sign. But the clinic decided otherwise, sent an ambulance, moved fast, hauled me out of the house, injected me with a bunch of anti-stress drugs, threw me into the emergency room, where I laid on a gurney in a state of delirium most of the day, I think that was still Tues (went in ER about 2pm out 8pm). I was wiped out. Got a course of Paxlovid (I know, rebound effects lurking with this stuff). Got an albuterol puffer (this is what I really wanted), got some antibiotics because that’s what Emergency Room’s prescribe (in case I have pneumonia or something other than COVID) because my lungs were half full of fluid via chest x-ray.
I did get home that evening on the 16th, I'm still in bad shape, didn't sleep that night either, but I now wasn't choking for breath. Now from the 8-17 forward a few new symptoms appeared, nausea and diarrhea (likely from antibiotics, Paxlovid, COVID. I note that Debra and Justin both experienced Nausea and diarrhea. Then the 8-18, basically feeling like a zombie trying to get some sleep. Today, I feel bad, but I can write a little. It's been a slow, painful, headsplitting-eyeburning-moralcrushing crawl out of this COVID hole and who knows how it will go with long COVID.
I don’t think I was denying COVID for this to happen to me. In fact, I was still in the ultra-vigilant group. But, I can’t control others in my household. Not that I blame my own son, but he had not gotten his booster shots (too much of a hassle). He may have started to experience what I will now label: COVID DENIAL SYNDROME. This is my own technical term, but I think it has merit.
And so the story goes, thank God, Heaven, Nature, Luck, I’m still here to write this blog.
…
What is in the Future
I am by no means a “seer” or a “prophet.” Let me make this crystal clear. However, there are many, many instances when clients have asked me what I would advise they do or how I would advise they act. I am a powerful resource for this advice as I’ve lived long enough, seen enough, studied enough, experienced enough to “modestly” at times, predict an obvious future outcome.
But, I’m very nervous to give advice. Why? Because personal change generally occurs when it is preceded by “personal discovery.” My advice is meaningless if there is not the right intrapsychic apparatus to evaluate such advice and then incorporate it in some shape or form into one’s own self-directed change formula.
A client once came to me who was being abused by her spouse. She asked me, Dr. What advice do you have for me. I indicated that the best thing to do was get out of the house, escape the current danger the client was in. Get outside help for yourself first. I gave her some phone numbers for local advocacy groups that do excellent work in this area. The client said, “Dr., I can’t leave now because I’m still in love with my husband.” There is no advice in the world I could have given this client because this client was struggling with a variant of her own form of denial. All I could do was warn her that I thought she was in danger if she remained living in that home with the abusive partner. Denial caused her to be psychologically unable to see an obvious source of harm or to hear a clear and obvious message that staying in the home put her in harms way. This is why advice needs to come from within a person, not from the external world, however accurate and well-meaning, for change to occur.
How does this relate to COVID in our current day and age. One approach to an answer begins in B.L. Miller’s, MD. JAMA 2020: 324: 2255-2256 article. “Science Denial and COVID Conspiracy Theories Potential Neurological Mechanisms and Possible Responses.”
I quote a paragraph below:
The US public health response to coronavirus disease 2019 (COVID-19) has been dismal, characterized by antimask behavior, antivaccine beliefs, conspiracy theories about the origins of COVID-19, and vocal support by elected officials for unproven therapies. Less than half of the people in the US heed health recommendations to wear a mask when out in public. Antiscience rhetoric has consequences. While only 4% of the world’s population resides in the US, the US has accounted for 20% of the world’s deaths related to COVID-19 and has performed less well than several other wealthy nations. Low science literacy contributes to denial of science. The relationship between antiscience viewpoints and low science literacy underscores new findings regarding the brain mechanisms that form and maintain false beliefs.
The argument in this article goes like this:
False beliefs are common in neurodegenerative disorders, particularly dementia with Lewy bodies and frontotemporal dementia. In neurodegenerative and psychiatric disorders, false beliefs range from accusations of theft, delusions of grandeur, to misidentification of people. Recent theories suggest that false beliefs emerge when there are neuropsychological impairments that (1) promote formation of false beliefs due to faulty sensory information and (2) hinder rejection of a belief due to faulty prefrontal systems that evaluate thoughts and beliefs.
The content of false beliefs in dementia with Lewy bodies and frontotemporal dementia differ but may offer insights into the shared neural mechanisms by which humans misperceive information. With both, the brain receives distorted sensory information that interferes with accurate interpretation of the world and lacks the circuitry needed to determine whether information received is true or false.
A recognized manifestation of dementia with Lewy bodies is Capgras syndrome, the false belief that a loved one has been replaced by an impostor.
Rather than engaging with information that is difficult to “see” and that may require changes in behavior, it may be easier to take in data that are simple and reassuring. Conspiracy theories may bring security and calm, as with the patient with frontotemporal dementia who is content to believe they are rich.
False beliefs about COVID-19 are also more likely to occur in someone who has faulty systems for monitoring and evaluating scientific information. This process of logic and reasoning is not accessible just to physicians or scientists. It is learned in elementary school and high school and is later sharpened by solving problems in work, college, and graduate school. If that process of balancing and comparing all sides of an issue is not taught, an individual is more susceptible to believing false information.
The author has done a fantastic job of making a cogent realistic point based on a rationally-informed premise, but still, the author is NOT correct. This person is, clearly, not a psychologist, nor does this person understand how intrapsychic processes work when an individual person (or social collective) perceives themselves on the precipice of an existential threat. ANNHILATION OF SELF IF ONE CONTRACTS COVID.
Although scientifically literate, or superbly schooled in the art of rationale comparison, it doesn’t matter. No one can short-stop the defense mechanism of denial. The reason is that denial is engaged outside a person’s conscious awareness.
So the story goes, if you are nearly sure you are going to get COVID, stop worrying and just forget THE FACT that COVID exists. When that occurs, something magical inside a person turns on, fear leaves, life returns to normal, COVID, for that person does not exist. Dying still goes on, suffering still goes on, but people stop talking about it. They just accept it. When I see denial-in-action, it is like one of the 7-wonders of the intrapsychic world, a beautiful sight to behold, how perfectly it works, even if it is terribly troubling at a social level.
I don’t claim this as an explanation, but it certainly explains historical phenomenon around what happened at the end of the “Spanish Flu” in 1918. To be brief, the Spanish Flu (which I have studied vigorously) actually lingered for quite a while (years and years) after the major pandemic was over. In this case, there was not an inkling of a cure or any form of medical protection. People (and even Science) just magically forgot the Spanish Flu existed. Sure, people still kept dying, as the records attest well into the 1920’s and 1930’s, but no one remembers any of this. Most of us, today, think, well, the Spanish Flu started in 1918 and ended in 1920. But, in 1920, that’s when the newspapers stopped publishing information about it, that’s when people stopped talking about it, that’s when even Science (at the time) moved on. They were, at that time in 1920 (2-years into massive dying), and over and done with the Spanish Flu. People really wanted to just go back to normal. Mass societal denial occurred.
In this case, it was truly massive denial. Even Science was over and done with the dying caused by Spanish Flu.
To quote from an article published in the Washington Post 2 years ago:
‘The 1918 flu is still with us’: The deadliest pandemic ever is still causing problems today.” Washington Post, Teddy Amenabar
By 1920, the influenza virus was still a threat, but fewer people were dying from the disease. Some scientists at the time started to move on to other research. …William Henry Welch, a famous pathologist from Johns Hopkins who was studying the virus, found it “humiliating” that the outbreak was passing away without experts truly understanding the underlying cause of the disease.
What I’m suggesting here is that the future can be guided by understanding predicable features of the human psyche and how the psyche responds to external threat. Denial is one way that people (and societies) have adapted to the threat of personal annihilation.
Some thoughts to consider.