Dr Ajit Bhide and Dr Nuzhat Khan on how families should copeMarch 17, 2020, 2:28 a.m. | Updated March 17, 2020, 2:44 a.m.
Parents are staying home from work, children are staying home from school, summer vacations are cancelled, and if this was not bad enough, there is the spectre of jobs being lost and futures being uncertain.
But with the government urging people to practice social distancing and self-isolation, people are forced to spend more time at home with their loved ones and families. There is a looming problem that is potentially damaging for families -- increased stress due to fear, uncertainty and simply, a very bad mood from being cooped with one’s family for days, almost like being a prisoner in one’s home.
The effects of stress on children could be potentially catastrophic if not handled properly.
Explocity spoke with renowned psychiatrist, Dr Ajit V Bhide, past President of the Indian Psychiatric Society to ask about how real this is and how people might cope with the stress.
(Explocity) People are afraid. Is fear normal?
(Dr Bhide) Fear is a normal and protective response to any threat to one’s safety. It is only when it is out of proportion or without any tangible cause that fear becomes pathological. The classic response to a danger is flight (running from danger) or fight (combating the danger). But before flight or fight, there is the other F: fright (even if subconsciously.)
What makes people anxious and often irrational? Possible job loss? What else?
Past experience, personal or vicarious (of someone very close), can generate undue or irrational fear. For example if one was witness to the death of a passenger on a train, he may develop a fear of train travel. Excessive thinking about the future in a pessimistic way may indeed cause such fear. Your suggestion of job loss as a possible cause, fits into this. Not that all fears about the future are unrealistic.
How can people address their anxiety?
The scout motto, ‘Be Prepared’ is the ideal way not to get into anxiety. But this is easier said and recognising one’s own fear as disproportionate is tough for most people. Regular aerobic exercise, a spiritual bent of mind, good non-anxious role models in one’s formative years, all help in reducing being anxiety prone. But if it happens, the best thing to do is open up about it to close and wise people in one’s social contacts such as a competent mental health professional (counselor or clinical psychologist or psychiatrist). Psychotherapy is hugely helpful; but in many cases medication may be necessary especially if the anxiety is severe or disabling.
Are children victims to the gloom surrounding coronavirus?
Very much so. Children are vulnerable and pick up cues from their environment very fast and often subconsciously. Parents who react to a crisis like the coronavirus pandemic with visible or even pervasive subtle anxiety, do affect their offspring’s emotional response, which of course is almost always tension and anxiety.
The coronavirus is isolating people from social contact but increasing family proximity. How would this affect families? Will they soon get on each others’ nerves?
Yes definitely. Let’s think about social isolation first. Social deprivation for days on end is going to cause an aggravation of the modern epidemic of loneliness and this could render a person morose, crabby, mentally confused and erratic in behavior. Social media, obviously can help reduce this but clichéd though it is, social media communication is a double edged sword. Morbid, even devastating effects result from rumor mongering and transmission of gossip. Being stuck with the same lot, even family, 24x7 can be irritating to either or all parties, but at least a little private time within these confines, and recognising why we are ‘locked up together’, helps reduce such tension.
What are some ways to cope with the situation?
Board games, playing cards, reading, listening to music, cooking together or each family member by turns can facilitate coping. It is most important to have a light hearted attitude in most of our interactions and this also entails not to react harshly if some member of the “incarcerated” group shows high irritability or has an emotional explosion.
What are some ways to help the kids cope with the situation?
For younger kids (pre primary and primary) a variety of activities including colouring, word and simple math games, learning music can be helpful. Older kids can engage in these too along with gardening (even of house plants) upgrading their tech skills and learning a new language. These are just some examples and we are lucky this coronavirus plague has happened at a time when the internet is easily accessible to most folks.
They say being stressed weakens the immune system. True? Will knowing this make people address their fears rationally?
Stress is a double edged phenomenon. Sudden, or too much, or prolonged stress does indeed undermine physical well being, including compromises in one’s immunity in some (but not all) cases. But a sanguine attitude, good guidance and healthy interaction within the confined group can go a long way in actually strengthening one’s physical health and “mental muscles”. It is like a mental gymnasium, we must believe we are given.
Explocity also spoke with Dr Nuzhat Khan, a Mumbai-based psychoanalyst (and Member of the International Psychoanalytic Association - MIPA), She said, “Fear is normal and has adaptive value if it is based on a realistic danger. If not, it becomes maladaptive and possibly counterproductive. Being anxious without actually deciding on a reasonable course of action will leave one feeling helpless and even more anxious. The best way to address the fear and anxiety is to be as well informed as possible without succumbing to fake information.”
Dr Khan spoke about the effects on kids, “Children are very much aware when people are afraid. This makes them anxious. They should be told about what’s happening in a calm way. They need to know their adults are able to look after them and are not getting hysterical about it. Use the time wisely rather than fret about not being able to go about things as usual. This is part of being an adult; accepting one’s circumstances and making the most of them.”
Asked about the potential issues from the standpoint of the traditional families where the men typically go to work and now stay all day at home, Dr Khan asked people to be respectful about sharing space. “As for too much togetherness, it will require people to be thoughtful about sharing space without being too invasive or demanding. A tough call for Indian men perhaps who will be wanting to be waited on all day,” she smiled.
Both Dr Bhide and Dr Khan share the view that an easy way for the family to cope is to find ways to enjoy their time together even if this was forced on them.
Dr Khan summed it up, “Perhaps this is a good time to do things together that ones never had time for. Pull out those board games, Try and maintain a balanced schedule for kids with perhaps some study time. Anxiety and obsessing over it will not be good for anyone for sure but neither will denial and ignoring real risk.”
“When this storm passes,” Dr Bhide concluded on a note of optimism, “we are going to be stronger in the long run, provided we have the right attitude.”
He offered this analogy, “We have a bit of potato, a bit of stone and a bit of egg about us, if we think of boiling water, as a metaphor for stress. An egg placed in this boiling water has its soft interior becoming harder and harder: these are people who become toughened by stress. A potato which is firm initially becomes soft and malleable in the boiling water: persons who are broken down by stress.A stone on the other hand remains unchanged in the boiling water. So be more of a stone, a fair bit of egg and just very little potato!”
ABOUT DR AJIT BHIDE
Dr Bhide is a leading and reputable psychiatrist, psychotherapist and thespian.
He says he has the dubious distinction of finishing his entire education in a radius of 4 km, which he insists did broaden his horizon. He is an alumnus of St Joseph’s Boys’ High School, St John’s Medical College and NIMHANS.
He has served as Head of Psychiatry at St Martha’s Hospital, for 33 years now and is also in private practice. He is Past President of the Indian Psychiatric Society at the Karnataka state, South Zone and National level.
Popular speaker at public and academic for a and has conducted workshops for schools, colleges and corporates. He has acted in about 40 plays, directed about 20 and also acted in three movies.
Dr Bhide’s areas of interest: Preventive Psychiatry, Child Abuse and its Long Term Sequelae, Adolescent Mental Health, Family Issues in Mental Health, Poetry, Creative writing, Literature, Indian Music and History, Performing Arts, and most importantly Psychotherapy.
ABOUT DR NUZHAT KHAN
Based in Mumbai, Dr Khan is a psychoanalyst and Member of the International Psychoanalytic Association (MIPA). She practices and also teaches and supervises those in training. Dr Khan conducts lectures and talks to increase awareness and understanding of psychological and emotional issues.