The Art of Balance in a Global Crisis — Step 1, Detect

Among my clients, friends, and family, those who are doing well in the pandemic have accepted that this is the way the world is now. They’ve arrived at a modified way of life that feels safe, and from that base of safety they’re looking for opportunities during this crisis and beyond.

But they didn’t start out doing well, and neither did I.

Shifting from the breakdown of denial to full detection of imbalance happened in stages.

After denial, our first response is usually a strong, troubling emotion: anxiety, depression, confusion, sadness, anger, fear, or a combination two or more of these feelings. For most of the people I know, the initial response was fear, and that was also mine.

There are two basic types of fear: the anxious and continual ringing of an emotional alarm bell, and the more deeply felt, threat-to-existence-level fear.

My cancelled birthday dinner was on a Friday evening. Sleep came uneasily that night, as I lay awake debating which kind of fear I was feeling. I knew that New York City was getting bad, but I kept asking myself, Would this disease really make it out to my quiet suburb north of Boston?

By Saturday morning, I realized that I should make sure my clients were “safe,” just in case the virus had already made it to my area. I scoured the Internet for ways to better ensure that my office and waiting room were free of likely contamination sources. Then I wrote a set of guidelines I planned to give to each client. I spent a couple of hours diligently perfecting each sentence, as if grammar, spelling, and punctuation would someone protect them and me. I printed 50 copies to leave in my waiting room and to hand to clients directly when they came to see me. This felt satisfying.

To minimize the number of objects I’d have to sanitize between clients, I collected neutral-colored bed sheets to cover the waiting room bookshelves, and I hunted around for containers to store the therapy fidget toys, candy jar, and puzzles. This, too, felt satisfying, as if I were designing a safe zone that was not only psychologically safe, but also physically protective of myself and my clients.

All this busywork made sense to me at the time and felt like the responsible thing to do, and it pushed the incessant call of fear to the background. But as I imagined actually covering surfaces with sheets, spraying furniture and door handles with disinfectant, handing my safety plan to clients, and constantly judging and adjusting the distance between my clients and myself during sessions, I realized that I’d been on a fool’s errand. My office and waiting room were perfect disease vectors for the coronavirus.

As fear clawed its way to the surface once again, I understood that if I were to continue as a therapist at all, I’d have do it from a distance, and I’d have to act quickly to set that up.

I spent the rest of the day researching insurance requirements for “telehealth,” educating myself on secure video platforms, and thinking about the best way to set up a makeshift “virtual office” in my home or my office. By 2:30 am, I arrived at what I believed would be a workable system.

Much as I’d like to say that my first concern was for my clients, if I’m honest with myself, I have to admit that my concern was equally for my own safety and for my girlfriend’s. I’m 69 and have three of the underlying conditions I’d seen mentioned, in the South China Morning Post articles, that appeared to be associated with higher risk of death from the virus, and my girlfriend was similarly vulnerable. Of course, though my clients are all considerably younger and, I gathered from those same Chinese reports, less likely to die from the virus, I was also concerned for their physical wellbeing.

I went to bed feeling satisfied, once more, that I had a reasonable plan of action, but when I opened my eyes Sunday morning after another fitful night, my first sensation was of fear roiling in my chest like heartburn.

Scenes from the many apocalyptic novels I’d read and movies I’d watched since I was a boy came unbidden to my mind’s eye. I knew how panic plays out, and I’d seen how people in my area behaved when they felt threatened, even by the announcement of a snowstorm.

“We have to buy groceries,” I told my girlfriend. “They could sell out if we don’t go now.”

Concerned that everyone else was thinking the same thing I was, I tried Whole Foods online, but found it was impossible to get an order through. Fear bumped up another level. “We might be too late,” I said.

My girlfriend suggested Crosby’s, the small grocery near her home. Crosby’s was in a wealthier, less-populated suburb. Perhaps people were less likely to be fearful there. “That’s a good idea,” I said. “Let’s go now.”

At Crosby’s, the only sign of panic buying was the nearly empty shelves of meat and paper products. While I scurried up and down the aisles gathering a month’s worth of coffee, tea, yogurt, cheese, beans, grains, bread, dried fruit, and nuts, most of the other shoppers were putting into their carts what looked like their usual weekly assortment. Only one other man had a cart as full as mine.

Nobody wore gloves or masks, and nobody seemed to feel the anxiety emanating from me in waves. Was I blowing this thing out of proportion? Yet the fear did not subside. Only when the entire backseat of my car was filled with a month of provisions did I feel a modicum of calm.

I spent the rest of the day and late into the following morning testing HIPAA-compliant video platforms, setting up my virtual office, configuring a webcam, and emailing each of the clients I was to see that week to let them know about my decision to go virtual.

This, too, felt satisfying but at the same time, I was beset with doubt. I am a therapist who relies heavily on my senses, noticing subtle signs of how clients might be doing as soon as I see them in my waiting room. Could I be an effective therapist through a video screen? Would my clients even be willing to do therapy this way? Was this a career-ending move? I knew the answers to none of these questions.

I had to accept that I’d done all I could to be ready for Monday morning. But then I began to fret about finances. My investment portfolio, which had been only one year away from what I’d need to retire, had already dropped significantly. Would it bounce back, as my friends seemed to feel? Also, typically, I received two or three requests from potential new clients every week. I hadn’t had a new request in more than two weeks. What if that potential income stream dried up, and I was left few savings and no clients?

With fear bubbling in my chest again, I wondered, If I’m this close to panic myself, how can I be the wise, calming voice that any clients who do show up online tomorrow will count on me to be?

Such were my first few post-denial days.

Over the next few weeks, chaos reigned.

The first week of virtual therapy passed in an intense, yet strangely insulated, way. I “saw” most of my scheduled clients, and I found that I was able to rise to the occasion. Each morning, I woke from an anxious dream and stepped into an actual nightmare. But by the time I went on screen, I inhabited the persona of the person my clients had come to rely on, reverting to the more fragile version of myself only after the last client signed off.

From my many (literal) windows into my client’s lives, I was able to see not only their pets, kitchens, and bedrooms, but also how we were all awakening from denial in different ways and at different rates.

My older clients were most afraid of death. What hit others first was financial fear. A few asked me if this was the end, not only of the world as we have known it, but for humanity itself, echoing the apocalyptic song by R.E.M.

It’s the end of the world as we know it.
It’s the end of the world as we know it.
It’s the end of the world as we know it and I feel fine.

Few, however, were feeling fine.

It was, as Dickens put it, the best of times and the worst of times.

Around town and through news reports I saw the familiar scenes from apocalyptic stories playing out.

Many responded to their fears with “every man for himself” actions, swiftly cleaning store shelves of masks, gloves, toilet paper, hand sanitizer, disinfectants, and other defensive supplies, and stockpiling kitchens and basements with months of meat, canned goods, and frozen foods, scooping up more far more than their fair share. Some added guns and ammunition to their stockpiles.

Others fled urban areas to less-populated regions and to national parks, hoping to outrun the virus. Still more retreated into depression, paralyzing anxiety, or back to denial, treating shelter-in-place orders as vacations, unfair impositions, or foolish overreactions, even as tens of thousands of Americans were dying from COVID-19.

In the absence of coherent guidance from above, and in the presence of a bewildering preponderance of conflicting opinions, preposterous false cures, and bogus safety measures proliferating through social media even more rapidly than the virus itself spread through the human population, we lost our way, unbalanced not only in our individual lives, but also as a nation and a species.

On stages large and small, we showed our true colors. Those of us with a predominantly generous and kind nature acted out of altruism. Those of us with a predominantly selfish nature satisfied their greed.

Thousands of low-paid food service workers and overworked medical staff sacrificed their health and sometimes their lives, and therapists like me absorbed the fear and anxiety of a wave of returning clients whose previously intact lives, the labor of months or years of therapy, had come undone.

On a global scale, as the virus and our response to it have transformed the human world, the rich have grown richer, the poor much poorer. Large companies have sucked up emergency benefits intended for small businesses, and those small businesses have collapsed, adding their owners and employees to the tens of millions who had already lost their jobs. While the wealthiest man in the world added $24 billion to his coffers, millions more around the world are on the verge of starvation.

UnBalancer loves this kind of thing.

Within a few weeks of the State of Emergency declaration, many of us found our way to a sense of personal safety, a personal bubble.

Bubbles, of course, are still in the world, and they are fragile. Food shortages, stock market crashes, and the potential for bank closings also affect people in bubbles. Bubbles are built from a thin film of denial, and they can, and do, burst. A bubble in a pandemic is a bit like hiding in an attic during the Holocaust — a respite only as long as the SS stays away from your door.

But bubbles are also an effective coping mechanism, and they can help us carry on.

Inside them, many of us have begun to adapt to the every-changing “new normal.” We wear masks. We wash our hands. We keep our fingers away from our faces. We have our food and prescriptions delivered and wash packages before we put them away. We work and study from home. We take walks, bicycle, drive our cars, and ride our motorcycles through a world that still looks just fine. We visit our friends and family through videoconferencing, plates of glass, or at what we hope is a safe distance. Is that six feet? Is it ten? Does it depend on which way the wind is blowing?

And we hunker down.

From inside our bubbles, it is then possible to move toward the next phase of the Detect step.

Acceptance

The last phase of the Detect step is acceptance. Some reach it after our defenses have been eroded away, and for some the virus must reach out with its talons in a more personal way.

For me, the pandemic got real when one of my brothers tested positive for COVID-19. From that point on, the contagion was no longer “over there,” or happening to “other people,” or even a direct threat that I could, if I were careful enough, evade.

That’s when it hit home.

That’s when I finally accepted that the world I thought I knew, with its predictable continuation, was no more. Although my brother fully recovered, the last veil of denial was gone. Since that day, when I open my eyes in the morning, my first thought is, “Another day in the pandemic.”

What has given me some leverage in dealing with this topsy-turvy world is an intervention by a friend a few years after my NDE.

At the time, I was dealing with multiple sequelae of my hospital experience, some of them potentially fatal. I frantically consulted doctors and alternative healers, scanned the nascent Internet for diagnoses and treatments, and fretted continuously about my advancing and apparently undiagnosable conditions.

And then one day, I stopped fretting, scanning, and consulting.

My Buddhist friend emailed me this gatha, a cross between a poem and a prayer, with instructions to recite it several times a day, without judgment.

Please grant me enough wisdom and courage to be free from delusion.
If I am supposed to get sick, let me get sick, and I’ll be happy. May this sickness purify my negative karma and the sickness of all sentient beings.
If I am supposed to be healed, let all my sickness and confusion be healed, and I’ll be happy. May all sentient beings be healed and filled with happiness.
If I am supposed to die, let me die, and I’ll be happy. May all the delusion and the causes of suffering of sentient beings die.
If I am supposed to live a long life, let me live a long life, and I’ll be happy. May my life be meaningful in service to sentient beings.
If my life is to be cut short, let it be cut short, and I’ll be happy. May I and all others be free from attachment and aversion.

My first response was to resist his prescription. “I don’t want death and I don’t want a shortened life and I don’t care about ‘karma,’” I told him.

“Just keep repeating it,” my friend advised. “You don’t have to believe in it right now. You just have to do it.”

The first few times I read the gatha, the notion of becoming content with sickness and death made me even more anxious. But with each dutiful repetition, I grew a little calmer.

After a few days, my relationship with time changed. I sensed that whether I would live or die, whether I would heal by myself, with interventions, or not at all, was already out there in my future, waiting for me to arrive. I didn’t have to fret. I didn’t have to push. I just had to move through time, making the best choices I could, until my fate became clear.

That moment of acceptance was liberating then, and it’s liberating now. The same set of possibilities that existed for me on the day I received the gatha exists for all of us in this current crisis. Then, I was aware only of my own unknowable path. Now, all 7.8 billion of us are facing our unknowable futures together.

If there is one main factor that divides those of us who will thrive in this uncertain time from those of us who may not, it’s likely to be acceptance: of who we are, of how we got to where we are, and of whatever may come.

Any of us may suffer losses.
Any of us may come through this unscathed.
Any of us may die.
Any of us may live long and prosperous lives.
Any of us may have our lives, or our fortunes, cut short.

When we understand that each experience in the pandemic also has some richness to it, the scary outcomes lose some of their power to scare us. Then we can put our energy to doing the best we can, knowing that this is all we can do.

It’s all, already, there. We don’t need to fret. We don’t need to push. We just need to live our lives to the best of our abilities, and of the infinite possible futures, we will inevitably arrive at the one that is ours.

Technique: Radical Acceptance

A helpful concept for the Detect stage comes from Buddhist psychologist Tara Brach. She calls it Radical Acceptance.

Radical acceptance means fully accepting our situations, feelings, limitations, and strengths.

In these difficult times, we may worry that our futures won’t turn out the way we hoped, we may long for the way things were, we may grieve what we have lost. These are all normal responses to uncertainty.

But staying in this state of fear and longing and grief can tie up resources that could help us deal more effectively with the evolving present.

When we radically accept something, we don’t judge it, we don’t try to fight it, and we don’t resent it. We simply recognize that this is how it is, freeing up all the energy we might otherwise have expended on judging, fighting, or resentment. Then we can move into our futures with our resources, perseverance, ingenuity, and hope intact. And we can deal, with renewed openness, with whatever comes our way, recognizing both the losses and the gains that may come.

What to do:

The following practice is adapted from the many helpful guided meditations on Radical Acceptance in Tara Brach’s book Radical Acceptance: Embracing Your Life With the Heart of a Buddha.

Doing the practice takes less than ten minutes.

1. Sit in a comfortable, balanced position and close your eyes. Notice the structures supporting you and relax into them. Pay attention to the rhythm of your breath as it enters your body, fills your lungs, and exits.
2. Remember a situation that brings up feelings of anger, fear, envy, grief, or some other difficult emotion. See the situation in your mind’s eye. Hear, in your mind’s ear, any words that were said. Notice, in your body, any sensations that come up as you recall this situation, paying special attention to your throat, chest, and stomach. Notice any other emotions that may arise. Let yourself feel all these emotions and sensations.
3. Notice what happens when you resist the experience. While you are seeing, hearing, and feeling the situation, imagine creating a powerful stream of “no” and using it to push the situation away. Notice how much effort it takes to keep pushing. Imagine how much more effort it will take to continue to push as you move through time in the days, weeks, months, and years ahead. Feel the weight of this accumulated effort in your body. This is the cost of resistance.
4. Return your attention to your breath. Notice the air entering your body, filling your lungs, and then leaving your body. With each breath, allow the stream of “no” to subside and its weight to dissipate. Sense the shift in your body as you let this resistance go. Then recall, again, the difficult situation from Step 2, once again letting yourself fully see, hear, and feel it in your body.
5. Notice what happens when you radically accept the experience by saying “yes.” While you are feeling the emotions and sensations of the difficult situation, imagine creating a powerful stream of “yes” that draws the feeling into your heart. Embrace the feeling as you would a child who needs your attention and comfort. Say “yes” to the difficult feeling, and also say “yes” to the part of yourself that wants to push it away. This part, too, needs your loving embrace.
6. Notice any changes in your body as you continue to draw the difficult feeling into your embrace with the steady stream of “yes.” Do you sense a shift? A relaxation? Let yourself imagine the cumulative effects of saying “yes” if you continue to embrace the feeling in the days, weeks, months, and years ahead. This is the healing power of acceptance.
7. Return your attention to your breath. Notice, again, the rhythm of breath entering your body, expanding your lungs, and leaving your body. Let yourself acknowledge what you have gained from this meditation. Set an intention to say “yes” to whatever comes. Then open your eyes.

To be continued…

Copyright 2020, David J. Bookbinder