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Reframing Isolation

21 April 2020 - Dr Jan Orman

Think of all the people before us who have experienced prolonged periods of isolation. Astronauts, lighthouse keepers, drovers’ wives, polar explorers, Anne Frank and many others like her hiding from the enemy, jungle dwellers, prisoners, submariners and lone yachtsmen to name just a few. Some by choice and some not so. Many without company and the creature comforts that we all find so necessary and which we, confined to our own homes, mostly have.

How did and do these people survive?

I keep wondering about what we can learn from all these people who live in isolation or confinement. What strategies were put in place and what might the long-term impact of their isolation have been?

In his book “Man’s Search for Meaning” Viktor Frankl, wrote about surviving in Nazi concentration camps. He explores the differences between those who survive and those who do not and comes to the eventual conclusion that those who survive severe duress are the people who are able to find meaning and purpose in their day to day lives, however difficult that may be.

There’s a clue in that – find meaning in the small things. Focus on what’s happening right now and do your best with it rather than thinking about the uncertainties of the future.

Possibly easier said than done!

What does prolonged isolation do to people?

According to Tom Williams, a clinical psychologist with NASA’s Human Factors and Behavioural Performance Unit, NASA has conducted experiments to see what effects long term isolation is likely to have on astronauts. The most striking effect is the dramatic decrease in physical activity (and concomitant increase in sleep) but it’s worth noting that this is actually reflected in changes in brain function eg a decrease in activity in the somatosensory cortex. That means decrease in processing of touch, proprioception (awareness of the position of the body in space), pain and temperature. This might interfere with the ability to identify objects by touch for example or awareness of the body’s position – one of the reasons that astronauts have trouble walking when they first come back to earth.

That’s not to say prolonged isolation will damage our brains but it has the capacity to change the way our brains function – at least temporarily.

Williams has developed a mnemonic designed to help astronauts reframe their isolation.  I’m wondering if this might be food for thought as we help people who are struggling with Covid-19 enforced isolation.

CONNECT

C is for Community and encourages us to think about our isolation as a shared experience, something we are doing with others for the sake of everyone in the community. We are all “pulling together”

O is for Openness. Can we keep in mind the need to be open to the challenges we are facing and find creative solutions to them?

N is for Networks and a reminder to us to focus on our personal networks and work to strengthen them.

N is for Needs and the need to ensure that our personal needs are met, whether they be physical, emotional or psychological. We need to identify those needs clearly and find creative ways of meeting them. Whether it’s exercise or intellectual stimulation or something in between there is a creative solution if we are prepared to look for it. It may not be quite as good as the “real thing” but finding an interim solution will give us a greater sense of control in our lives.

E is for an Expeditionary Mindset – there are some things that we can’t change and some problems that we can’t solve. An attitude of curious non-judgemental observation may help. There may even be a therapeutic effect in writing it down like a journalist or historian reporting on this strange time in history.

C is for Countermeasures to Calm frayed nerves. Now more than any other time we need to have some stress and anxiety management skills in our repertoire. Perhaps its time for some formal relaxation techniques or, dare I say it, mindfulness practice.

T is for Training. Covid -19 has come on us out of the blue. The virologists and epidemiologist may not be surprised but it’s fair to say that the rest of us are pretty stunned by the illness, its ferocity and the impact that it is having on everyone’s lives. The important thing to remember is that this is not the first challenge we have met in our lives. Unless we are very small children or fairy princesses all of us have experienced challenges and setbacks in the past. They may not have been as big as the current challenge but we have had to meet them, survive them and devise strategies to cope. What we might need to do is remember the skills we have developed before and see those challenges as training runs for this “big event”.

 

Join Black Dog Institute’s Mental Health Community of Practice to stay connected with other health professionals during physical distancing: www.blackdog.org.au/CoP

Read the New Yorker article that inspired this post here.

Find out more about NASA’s Human Factors and Behavioural Performance Research.

Dr Jan Orman
Dr Jan Orman

Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.

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