The Covid-19 pandemic began at the beginning of March. Back then the Psychiatry and Clinical Psychology Unit of the Tor Vergata Polyclinic Foundation in Rome decided to provide the defusing technique to health workers, doctors and nurses to better face the emotional stress caused by the pandemic and the resulting organisational changes to hospital activities. Defusing is a technique utilised in military operational scenarios where one is forced to confront the enemy, the dangers of war and the resulting moments of tension, fear and anxiety.
In the context of the pandemic we’ve found ourselves facing something completely new. On one end the urgency to understand the quickest way to limit the spread of the pandemic and to apply the best and safest treatment options; considering the fact that in the Covid-19 pandemic everything is yet to be discovered and studied because, as we know, the way this virus manifests and spreads among us is not known. On the other end the conversion of the “normal” hospital into a frontline Covid-19 hospital caused anxieties and problems among workers due to the organisational changes and the risk of infection. It was therefore necessary to provide a technical and psychological support to all staff members.
We are faced with a still fairly new “world” and uncertainty is the foundation of our fears.
The fears of health workers
The fears that all health workers experienced changed over time. Initially the defusing technique highlighted very natural fears around: getting infected, having to change profession, having to use unknown safety protocols and the lack of personal protection equipment. Emotional sharing proved particularly useful as it allowed us to express and discuss common anxieties that we all shared. Moreover, those practicing defusion displayed a noticeable emotional and professional maturity.
The most significant emotional stressor to cope with emerged little by little but in a very evident way: the fear of infecting someone, whether it was a colleague, a patient or a relative. We therefore witnessed the presence of double stress factors in health workers: one stressor was linked to the fear of getting infected directly at work; the other was the fear of going home and infecting family members. It was a double fear that led to significant life changes: many opted for moving to another home and separating from their loved ones in order to avoid the risk of infection, thus bearing a further emotional and affective weight to manage and cope with. A nurse said: “I don’t have a safe place anymore, in any conditions, whether it’s at work or when I’m off. I don’t go back home but I go to another flat; I don’t have that peace of mind I used to have before”. In addition to everything else there is the great psychological uncertainty that the lockdown generated: we are faced with a still fairly new “world” and uncertainty is the foundation of our fears.
Redefining the near future
After witnessing the dramatic aspects of the emergency and the even more tragic numbers that describe its pandemic spread throughout Italy, it’s necessary to reflect on the future impact that all this will have on mental health. For example, from a formative standpoint the experience of the pandemic allows our postgraduates to understand new scenarios: for the first time they have a very significant exposure to death and loss, which entails having to think about mental health in this type of context. The dramatic circumstances that this experience brought along could lead us to explore, discover and better understand ourselves.
With the start of phase 2 the crucial goal is managing to restart without following old life models but begin to live imagining something different, wherever possible. It’s a challenge for our creativity, our ability to adapt and redesign our life. It will be a battle with uncertainty that will force us to make new decisions and to identify what previously held a superfluous role in our life.
A new mental health vocabulary
If I had to choose keywords to describe phase 2 I would definitively say freedom, imagination, culture and knowledge. It is essential to learn to reflect and to discuss empathetically for collective thinking to develop: nowadays you need to have the strength to think as a group once again. The challenge is around finding an empathic way of uniting that could improve our psychological resilience as a group. Reconsidering the importance of “culture” and “knowledge” might be sufficient to discover new essential values for our psychological and social wellbeing. We need something different: respect, altruism, the ability to know ourselves and others better in order to develop an increased ethical meaning of life, thus beating that “vital poverty” that causes the brutalisation of human relationships.
Nowadays you need to have the strength to think as a group once again.