Dr. Eli Somer outlines ‘problem-solving’ approach to pandemic’s psychological impact
During the earlier stages of the coronavirus pandemic in March, Dr. Eli Somer, a clinical psychologist and Professor Emeritus of Psychology at University of Haifa’s School of Social Work, warned that the “accumulative stress” of self-isolation could take a toll on many vulnerable people.
Subsequently, Israel’s Welfare and Social Services Ministry reported in May that there had been four domestic violence-related suicides in the country since the start of the pandemic. In a more recent conversation with the American Society of the University of Haifa (ASUH), Somer provided an update on the psychological impact of this ever-evolving crisis.
“In the face of a genuine threat to one’s safety, financial security, or self-esteem, reactions of distress are to be expected,” said Somer, who served as a mental health officer in the IDF and later as a civilian clinician for survivors of terrorism and childhood trauma. “The question that we are facing under such circumstances is: Can anything be done to decrease the threat?”
The following is the rest of Somer’s interview with ASUH.
Q: What advice would you give to people who feel helpless right now and what are the warning signs that can help us prevent further tragedies like suicides from happening?
A: “The best coping is ‘problem-solving.’ It is not only the most effective means to face the challenge, but it can also enhance the sense of self-efficacy and competence. The obvious example relates to the current situation: if the perceived threat is that of contagion, the best approach is to employ credible means to prevent contamination. People who have impaired sight, hearing, or cognition might not be able to adopt effective ‘problem-solving’ coping. To reduce their sense of helplessness, the vulnerable need to feel that they are provided with all the necessary information and assistance to ensure a healthy living. If ‘problem-solving’ does not reduce the experienced distress, individuals may need to practice ‘emotion-focused’ coping to manage the ensuing distress and regulate it. Examples of ‘emotion-focused’ coping include the utilization of social support, distracting and entertaining activities, and spiritual and religious practices. Warning signs indicative of serious mental distress and potential suicide include social withdrawal, visible signs and expressions of sadness and despair, increased use of alcohol or drugs, sleeping too little or too much, displaying extreme mood swings, talking about feeling trapped or being in unbearable pain, talking about being a burden to others, and talking about wanting to die or to kill oneself.
Q: Governments around the world are starting to ease their lockdown restrictions. What are the psychological obstacles some people may face as we transition from self-isolating back to our “normal” way of life?
A: “Most people are happy to resume their former lives and are resilient enough to emerge from the COVID-19 lockdown unscathed. However, many have no former lives to return to. Laid-off employees of the transportation, tourism, hospitality, entertainment, and restaurant industries, and owners of the countless business that went bankrupt, are a case in point. Others who might find it hard to return to normal life are recovered intensive-care patients who survived the COVID-19 illness and those who lost loved ones to the pandemic. These individuals will have to process their post-traumatic stress disorder (PTSD) and grief symptoms. Another vulnerable group is those with pre-existing mental health problems. Some of them may have experienced an exacerbation of their anxiety and depression symptoms during the lockdown. Mental health services will have to brace for a surge in referrals of post-coronavirus cases.
Q: Some facilities have announced that they are launching programs to tackle the enormous psychological impact of frontline medical workers who have been treating coronavirus patients. What kind of emotional and psychological support do these health care workers need moving forward? Is it likely that they have developed PTSD over the past few months?
A: “Frontline medical workers who have been treating coronavirus patients are definitely at risk for PTSD. Many have experienced a sense of helplessness in saving lives, others have had to exercise triage principles and give priority treatment to individuals with a better prognosis, and most have witnessed untold suffering such as scenes of people dying alone in alienated maximum isolation units. At a minimum, frontline medical workers would benefit from a chance to be debriefed about their experiences. Most would benefit from a chance to be pampered in an indulgent, compensatory rest and recuperation period.”
Q: Some are predicting that society will never fully return to the way things were. Do you agree? If so, how do you think people will forever be impacted on a psychological level from this pandemic? Are there any positive takeaways as a result?
A: “This is such an unprecedented event that I have no past reference on which to base my answer. Time will tell if people in more hard-hit localities will behave differently than those who lived in less affected areas, or if individuals in family-oriented collectivist societies fared better than those struggling in more individualistic societies. However, what will determine if pandemic-related stress persists is the existence of a cure or an immunization for the disease. Without a widely available evidence-based medication for COVID-19, I predict that people will be wary of crowded indoor spaces and people displaying symptoms of a cold. I believe that a potential positive takeaway of the pandemic will be improving our protective hygiene.”
Q: This pandemic seemed to have caught almost everyone off guard. Should a second wave arise, as some predict, what advice would you give people to steel themselves from this nightmare recurring in six months?
A: “My main concern is about the elderly population. I would advise families to consider inviting senior family members to move in with them. The abandonment of older people in retirement homes, isolated from their families and at higher risk for contagion, was a sad psychological outcome. Inviting the elderly into the bosom of their younger family will not only improve their medical chances of survival but will also prevent psychological injury caused by loneliness and helplessness.”