Last November, a team of Bryant faculty, led by Science Professor and Chair Kirsten Hokeness, Ph.D., organized a panel to discuss the interdisciplinary approach to outbreak management. Little did anyone know how timely this event and this topic would be.
“Since an outbreak tends to elicit a lot of stress and anxiety, and not just from those infected, it’s important to address the mental health needs of the population in addition to the physical health concerns.”
Psychology Professor and TEDxBryantU speaker Joe Trunzo served on the panel and discussed the importance of understanding and aiding in the emotional and behavioral responses to an outbreak. “Since an outbreak tends to elicit a lot of stress and anxiety, and not just from those infected, it’s important to address the mental health needs of the population in addition to the physical health concerns,” he says.
Trunzo’s research and clinical work focus on the psychological management of chronic medical illnesses such as cancer and Lyme disease, as well as the treatment of mood and anxiety disorders, especially OCD. In his book “Living Beyond Lyme: Reclaim Your Life From Lyme Disease and Chronic Illness" (2018), he shares insights and strategies for improving quality of life when coping with Lyme disease and other difficult life challenges.
Here, Professor Trunzo shares his expertise and guidance to help our community better understand these challenges and develop strategies to thrive during these challenging times.
How do anxiety and stress heighten your risk for getting ill?
Long term chronic stress will reduce the effectiveness of your immune functioning. It is well known that prolonged stress reduces lymphocytes, which are important cells in fighting pathogens (an infectious agent such as a virus or bacteria) and disease. Moreover, when we are stressed, we tend to change our behaviors, get out of our routines, and over-indulge to self-soothe. This may include veering off established exercise routines, eating poorly, using more alcohol or other substances, and disruptions to our regular sleep patterns. All of these can contribute to compromised immunity.
Be educated, of course, but as soon as you accept the situation you are in – that we are all in – the sooner you can get down to coping with it in a realistic and meaningful way and the better off you will be.
What are people most fearful and anxious about overall?
The unknown. There is so much about what is happening in the world right now that is just unknowable. How long will this last? How bad will it get? Will I get sick? Will people I love get sick? Will there be riots? Are my family and I safe? Nothing fuels anxiety more than uncertainty. If someone were able to step up to a podium and say with any sense of authority that this would all be over in two weeks, two months, or whatever, I think everyone would settle down considerably and get down to the business of getting through it. The problem is that no one can do that because no one really knows for sure. I think that is what people are most anxious about.
What are some effective ways to deal with the fear of the unknown?
Two things – accept what you cannot know and then focus on what you can know. Unless you are a scientist working diligently on figuring this out, knowing anything about how this will all play out is impossible. The more you try to know things that you can’t know, the more you seek certainty in an inherently uncertain situation, the more you waste your time, energy, and emotional fortitude. Be educated, of course, but as soon as you accept the situation you are in – that we are all in – the sooner you can get down to coping with it in a realistic and meaningful way and the better off you will be.
Do these things to feel better. Don’t wait till you feel better to start.
What are some of the ways people can manage / reduce anxiety?
This may sound strange coming from a clinical psychologist, but I’m actually not a fan of trying to reduce anxiety – it tends to lead to worse outcomes. When faced with a situation over which you have no control, the worst thing you can do with anxiety is trying to control, escape, avoid, or extinguish it.
The paradox of anxiety is that the you more you try any of these things, typically the more your anxiety will grow. Maybe not in the short term, but definitely in the long term, so acceptance is key here.
Reconnect with yourself and your values. We’re in it, and we don’t have much choice about that right now, so focusing on what we can do to move ourselves forward in a meaningful way, while in the midst of that anxiety, is the way to go. Identify what is important to you, what you truly value – your health, your family’s health, learning a new skill, working on your home, helping others, staying connected to people, whatever that may be, figure it out. This is all you – you get to choose what matters to you. Then do anything and everything you can that is in service of that value.
Exercise more. There are lots of online videos about exercising in limited spaces. You don’t need a gym to get or stay fit. Go out for walks or runs in open spaces (social distancing!) if you can. Take a free online course, learn a new language, start playing that guitar or keyboard that has been in the corner forever.
Be productive. Check in with friends and neighbors, see who needs things, help where you can. Maintain some sense of structure and routine, eat as healthfully and enjoyably as you can, sleep well, be creative, write, read, sing, dance. Clean your house, get those long waiting projects done – be productive in whatever way matters to you – something, anything, every single day.
Turn off the news. Yes, turn off the news, sit back, breathe, have some perspective. Do not allow yourself to become consumed by this or your anxiety about it.
Do these things to feel better. Don’t wait till you feel better to start. Being anxiety-free is NOT a prerequisite for doing anything I just listed. You can do any of them, even if you are stressed. It may not feel as great as it would if you weren’t anxious, but I promise a better outcome if you engage in meaningful activities versus trying to control your anxiety.
Social distancing. Everyone is the world is being told to keep our distance from others, but what is the impact of this short-term and long-term. While distancing is helping in one way, is it causing harm in another?
We are social creatures, so limiting contact, touch, and being in the presence of others is inherently difficult for us. The literature is packed with data on how social support and connection to others is a critical component of our overall health and well-being. Social distancing puts a huge dent in our ability to do that, but thankfully we live in an age where technology can help greatly with this. Texting, video conferencing, and responsible social media use are all antidotes to this, and we need to take advantage of that as much as possible.
It’s interesting to note that most people are abiding by government recommendations and instructions. Can you speak to why there’s been such widespread cooperation and positive behavior? Is there anything that can be done better?
First and foremost, I think most people get the seriousness of what we’re dealing with and want to do their part. We’re generally prosocial creatures, and despite the examples you see on the news of people ignoring the recommendations, most of us are chipping in and are doing what needs to be done. I also think that the technology I mentioned earlier makes it easier to be physically distant because there are other ways to connect socially. That makes adherence easier.
Find your people, connect with them in whatever way you can, and dig in together. Even though we are all isolating, no one is alone in that isolation.
Through your work with people with Lyme Disease, you help people thrive with a debilitating health condition. What is the most effective way for people to thrive in this crisis, including those who are suffering with coronavirus and their families, those affected by shutdowns, unemployment, and financial strain, and everyone trying to abide by social distancing recommendations?
These are obviously very trying times. I think the greatest comfort comes from the fact that this outbreak is affecting everyone in one way or another, regardless of whether you get sick. Often the most difficult part about being ill or dealing with a chronic illness is that you feel alone in your pain. It is rare that an event has this level of global impact, so the fact that no one is in this alone, that whatever effect this is having on you is also affecting millions, if not billions of others the same way, is comforting. The irony is that we are all in our isolation together. Support groups for chronic illness sufferers work wonders to improve quality of life and aid in coping. The entire world is a support group right now. Find your people, connect with them in whatever way you can, and dig in together. Even though we are all isolating, no one is alone in that isolation.
How can those dealing with fear, anxiety, and pre-existing mental illness get the treatment and help they need when unable to meet with doctors, counselors, and other healthcare professionals in person?
Luckily, in response to the crisis, most states and insurance companies are relaxing previous restrictions on telehealth services, which means providing behavioral health treatment via phone or video conference is much easier and more affordable than it has been in the past. However, I expect the emotional and behavioral impact of the long-term consequences of this to be significant and long lasting. The behavioral health community will have its hands even fuller than they already were for quite some time as a result of this crisis.
Why is it so important for psychology and behavioral experts to be an integral part of crisis management?
Everything about spread prevention with this virus is about behavior. Social distancing, hand washing, coughing and sneezing etiquette, maintaining a good diet, getting enough exercise, getting enough sleep, managing stress, etc. These are all areas that psychologists and behavioral health professionals help people with every single day. Behavior change is hard, even under circumstances as dire as these – it doesn’t always just happen because people are told to do it. In conjunction with other health professionals and communication specialists, behavioral health professionals can and should be involved in the development and implementation of spread prevention policies.
Joseph Trunzo, Ph.D. is Professor of Psychology and chair of the Department of Psychology at Bryant University and a licensed, practicing clinical psychologist and founder of Providence Psychology Services in Providence, RI. He is a member of the American Psychological Association, Association of Contextual & Behavioral Sciences, and the International Lyme and Associated Diseases Society.