The Reluctant Psychoanalyst: Covid-19 and Hans Selye’s General Adaptation Syndrome

Hans Selye's General Adaptation Syndrome

This posting is about the psychological response to the Covid-19 situation. I am using Selye’s General Adaptation Syndrome to talk about our psychological response to the world being suddenly a different place – I don’t know enough about virus response to even know if Selye’s Syndrome applies to Covid-19 itself.

Selye’s General Adaptation or Stress Response Syndrome was originally created to describe how the body’s immune system reacts to invaders like viruses and germs that are attacking it. It has been adapted for use to describe psychological response to stress as well.

Walt Menninger pulled out an article he had written where he had changed the terms and called it the “morale response curve” when I arrived for a Post-Doc at the Menninger clinic. He predicted that our morale would slump as we tried to find our way around town and get used to the routine at the clinic. I was actually pretty jazzed about being there, and Topeka isn’t too hard to navigate, so I didn’t find it all that useful at that time.

But it does seem applicable to my own current experience, that of my students, and of my patients, at least as I can ascertain so far, as we adjust to social distancing and the specter of a pandemic and its economic and social consequences.

Selye suggested that, when we are faced with a challenge, our immune system is essentially shocked by that. In the immediate wake of the shock, we are less capable of dealing with things than we were before the shock. Our antibodies are a bit knocked off their pins.

I think this has happened to us psychologically on two levels with Covid-19. One is existential. I reported on my experience a week or so ago (though it seems much longer ago than that). There is the sense that the world will be a different place. And the anxiety associated with that leads to our ruminating about all that will happen and that is one level of stress.

The second level is that everything is different. We are no longer going to work. We have five adults living in our house together where only two weeks ago we had three (our oldest daughter is taking a gap year and saving money by living at home). I keep think there is somewhere that I’ve got to be, but if there is, it is generally on a screen.

Mark Solms has taken the position that what Freud meant by the unconscious included routines that we have learned to deal with stuff – and these are learned and deployed unconsciously – in part because they are learned as procedures and stored in procedural memory – which is the memory where we store the ability to ride a bike. This stuff takes a long time to learn, but once learned, it stays around for a long time.

Solms maintains that the reason for this is that it is very expensive to do things consciously – it requires a lot of energy and a lot of things are always competing for our consciousness. So we have to prioritize – what do we want to think of now? And now? And now? Better to just have most stuff running on the back burner – to trot out a routine to deal with and do the stuff unconsciously.

Well, we have had to do a lot of things consciously lately. We have had to figure out how to have meetings with our clients by phone, and to figure out the legalities of that. We have had to figure out how to have discussion classes by Zoom – easy with a class of eight – not so much when there are twenty people in a virtual room. And we have had to figure out how to unpack our groceries without contaminating our homes.

So we are tired. We have been expending a lot of energy dealing with the big questions and addressing a hundred tiny details – and deciding which of those details are worth attending to and which we will let slide for a little while.

The nice thing about Selye’s curve is that he suggests that, once we recover from getting knocked back on our heels – we will actually improve our defensive functioning. We will, in the world of illness, figure out how to fight the invading viruses or bacteria – and, in the world of psychology, figure out how to make those unusual processes become habitual – turn the conscious problem solving into unconscious procedures which will help the whole system hum.

In fact, we will be better able to manage novel situations for having survived this one. We will have discovered new tools and the system will be better prepared than it was before.

Well. Isn’t that a happy thought?

But there are some nagging concerns. Some people have taken the position that this will change the way we do things in fundamental ways. On the macro scale – we are living in an era when epidemics are not a big deal.

Our local radio station ran a story that, in the eighteen hundreds, it was not unusual for there to be an epidemic – of typhus, or cholera, or influenza – every few years. And often these would take 10 per cent of the population. In the 1500s, as the Renaissance was swirling through Florence, so was the plague and twice during that one century the city lost half of its inhabitants – and continued to become the place that would produce some of the greatest art the world has ever known.

But we don’t live in such an era. Death is rare for us. So is, at least for those of us who are doing well, economic hardship. To practice social distancing will cause economic problems across the spectrum – though of course, those at the bottom of the scale will suffer more (though those at the top may scream louder about it). Some are beginning to propose that we should not “flatten the curve”, but simply be done with it. Take the huge losses and move on with our economy in tact.

If we don’t choose to do that – and I hope that we don’t – we will have thrown down a gauntlet. We will be stating that human life is, indeed, quite valuable. The cost per person saved will surely be calculated, and it will be very high. And we will know – even if we later deny it – that this is an essential value that we share.

But there are smaller scale issues that will emerge as well. For instance – a Psychology Today blogger has proposed that we will move to having all psychotherapy take place virtually.

Some of the therapists I work with like this idea. There is less rigmarole about having to go out to the waiting room to get patients. This feels more efficient. And for patients, too. They don’t have to drive across town to see their therapist. Isn’t that more convenient?

But, no, some of my patients, students, and the biggest part of myself screams. We need to be in a room together. How are we going to feel our ways into each other’s lives if we can’t hear each other breathe? If we don’t have the same shared world? Especially in talk therapy – especially when we use a couch and there is very little eye contact, saying hello and goodbye becomes more, not less, critically important.

At least at the initial stages, for those of us who are not sick yet and who do not yet have family that have been severely affected, the biggest change is the social isolation of social distancing. Will we find that we prefer this? It sounds like an introvert's dream. But my sense is that even those among us in whom the urge to be in contact with others beats more faintly will discover that the sound of that drum will increase as the time of our separation extends.

I really do think absence makes the heart grow fonder. Perhaps we will emerge from this a stronger, gentler and kinder group of humans.

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The Reluctant Psychoanalyst

Saturday, March 28, 2020

Covid-19 and Hans Selye’s General Adaptation Syndrome

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