Coping with COVID-19 - Part 3: Paying Attention to Your Emotions

Another way for us to deal with our anxieties is to calm our limbic system or emotional brain in order to allow our rational cognitive brain to be heard. As mentioned previously, the purpose of the amygdala is to monitor danger in the environment. When we are faced with an actual threat (such as a Mack truck bearing down on us), then fear and a subsequent fight-or-flight reaction is not only functional, it’s essential for our survival. Fight-or-flight symptoms – chest tightness, difficulty breathing, nausea, a racing heart - are much more prevalent these days. These symptoms of a panic attack are often mistaken for COVID-19 itself (though the latter typically develops slowly along with a fever and cough). Of course, for individuals with cardiac risk factors, they also need to be distinguished from a heart attack.

When fear or panic becomes chronic and doesn’t result in any immediate action, then it leads to ongoing anxiety which interferes with our ability to plan and to effectively engage our cognitive brain. Therefore, the goal of emotion regulation strategies is to avoid overloading the emotional brain (so that it will still be alert if the need arises) thus allowing the cognitive brain to serve its function.

The best way to understand how emotion regulation develops is by considering a parent’s interactions with his/her infant. This process is called reflective functioning.[1] In a secure parent-child relationship, the parent pays close attention to the infant’s facial cues and notices when the infant seems distressed. The parent then gently mirrors the infant’s facial expressions through either her words or her own facial expressions, thereby letting the infant know that he/she is being heard and seen - thus validating the infant’s emotions. But the parent doesn’t stop there – she then responds in a different way by attempting to soothe the child and to fix whatever has been bothering the child. This type of parent-child interaction is so important that it literally facilitates the development of the infant’s limbic system or emotional brain. It’s a problem if the parent doesn’t mirror and validate the child’s emotions and it’s also a problem if the parent doesn’t then step back and find a way to comfort the child. The child internalizes this process and eventually learns how to soothe him/herself by following these steps even without the parent’s presence.

This process of reflective functioning is also a good model for how we can best regulate our emotions ourselves as adults. The first step requires us to pay attention to our body (just as the mother pays attention to the child’s facial expressions), thereby validating what we are feeling. There are many ways of becoming more attuned to our “here and now” internal experiences, including walking in the woods or in nature, gardening, engaging in a (virtual) gentle yoga or tai chi class, downloading an app that will teach us meditation exercises, and turning off the daily news or social media that increases our anxiety. Listening to some calming rhythmic music such as smooth jazz, folk music or classical music similarly allows us to set aside our thoughts and just be attuned to our body. In essence, we are doing for ourselves during a stressful moment what we hopefully had been lucky enough to receive from our parent – tracking, monitoring and even describing the physical sensations in our body instead of being distracted by worrying about what to do.

After settling our body and our emotional brain, the cognitive brain then is able to take over, to plan more effectively, to make good decisions, and to help us resolve our worry. We are thus more able to empathize with and to be gently comforting and reassuring to ourselves – perhaps forgiving ourselves for our fears, giving ourselves some slack for not being so efficient with our newfound time, and even reflecting on our current circumstances (perhaps creating a gratitude journal in which we write down three things each day for which we are grateful). We are also more able to extend this empathy and comfort to others – in essence, to engage in the supportive relationships that I’ll describe in the next two blogs.

[1] Fonagy, P., Target, M., & Gergely, G. (2000). Attachment and borderline personality disorder: A theory and some evidence. Psychiatric Clinics of North America, 23, 103-122.