By Robert Most, Ph.D., President, Mind Garden
March 31, 2020
During this stressful period of COVID-19 pandemic, I reached out to my colleague Dr. Margaret Chesney, Professor of Medicine at the University of California, San Francisco, who has spent much of her career studying stress and coping, particularly in response to illnesses, including viruses. Here, I share some of Dr. Chesney’s recommendations for coping in the time of COVID-19, and I suggest some products that might be helpful.
Dr. Chesney notes “what is so stressful about COVID-19 is the fact that becoming infected is not entirely under our control, and moreover, the consequences of infection can be deadly.” The very definition of stress is “a threat that exceeds our capacity to respond.” Clearly, COVID-19 is a threat and a source of stress.
Dr. Chesney describes the two primary approaches we use to cope with stressors like COVID-19: problem-focused coping and emotion-focused coping. In coping, we must recognize that there are aspects about COVID-19 over which we have some control and other aspects where we do not have control. Additionally, the stress of COVID-19 may leave some of us with a range of physical and emotional responses, including fatigue, distress and anger. Approach #1 – Problem-focused Coping:
For the aspects of the COVID-19 over which we have some control, our coping is best focused on addressing those aspects, those problems. “For COVID-19, that involves using all of our problem-solving skills to avoid coming in contact with the virus.” These are actions we can take. The focus of our coping efforts is directed at the problem itself.
Problem-focused Coping for COVID-19: This includes becoming very proficient at changing our behavior so that we reduce the likelihood that we come in contact with the virus. This involves frequent handwashing and being aware of how the virus is spread. It also involves being very careful when venturing from home, paying attention to keeping distance from others, and being aware of what we touch, using gloves, wipes, or hand sanitizer. With this approach, we are using our problem-solving skills to counter the threat of COVID-19 where we have some control. Other actions include setting up so you can work from home if possible, buying recommended supplies but not to excess, and finding productive ways to make use of your new time that don't require going out. Approach #2 – Emotion-focused Coping:
Dr. Chesney notes that one particularly challenging aspect of COVID-19, like many stressful situations, is that some aspects are not under our control. COVID-19 brings to us the threat of possibly becoming very ill and dying. As we do not have control over these aspects of the pandemic, our coping here is best focused on managing our emotions with all our stress-reducing skills. These are actions we can take but they are focused on our emotions.
Emotion-focused Coping for COVID-19: This includes developing an awareness that we may have a range of emotions about the virus, including fear, depression, and anger, which are all very real and entirely justified. But if these emotions are not addressed in a healthy way, they can interfere with our best problem-focused coping. For example, some people may drink alcohol or use drugs to reduce their distress. For others, hoarding is a way of taking an action that they hope will make them feel safe. They question, "Do I have enough ... toilet paper?” By contrast, more constructive approaches really help us center and get a grip on our emotions -- like deep breathing, mindfulness meditation, and physical activities, e.g. a brisk walk. In this way, we use our skills or activities focused on our emotions to reduce the stress associated with COVID-19.
Dr. Chesney observes, “Those people who are particularly proficient at coping, who have high ‘coping self-efficacy,’ use skills from both their Problem-focused Coping tool kit and their Emotion-focused Coping tool kit.” With COVID-19, as with any stressor, we need to use problem-focused coping strategies for the aspects of our situation which we can change or control, and use emotion-focused strategies to help reduce the emotional distress that this situation can have on our emotions and sense of well-being.
Research shows that if people use an inappropriate coping strategy, e.g. try to change what cannot be changed, they are more likely to experience worse distress and even physical illness. The years of work by scientists, including Dr. Susan Folkman, Dr. Arnold Lazarus, Dr. Margaret Chesney, and others, is captured in the well-known saying :
|Change what can be changed|| * * * ||Problem-focused Coping |
Washing hands, maintaining social distance
|Accept what cannot be changed|| * * * ||Emotion-focused Coping |
Mindfulness, Physical activity
|Have the wisdom to know the |
difference between the two!
| * * * ||Developing Coping Self-Efficacy|
Social Support coping is another important coping strategy endorsed by Dr. Chesney. We are “social animals” and we benefit from being in touch with others, even if not in close physical proximity. Others provide us with encouragement, support, a sense of belonging, and often have suggestions for both problem- and emotion-focused coping. She recommends during this time to reach out by phone or computer to be in touch with friends and family.
You can learn more about your coping style and ways to cope with the Ways of Coping Questionnaire
and Coping Resources Inventory
. Mind Garden also publishes a helpful coping workbook, Understanding & Managing Your Stress
. To measure your stress level, you can download the free Perceived Stress Scale
Mind Garden will soon be publishing the Coping Self-Efficacy Scale (CSES) by Dr. Margaret Chesney. Dr. Chesney has worked with investigators worldwide over the last 15 years using the CSES. The instrument has many translations, including a new Italian translation used in a study of physicians treating COVID-19 patients. The CSES measures how confident one feels with various coping methods. The CSES Individual Report will be valuable for learning coping techniques and when to use them appropriately.Margaret Chesney's page at UCSF