Bina (right) and a friend wash their hands at their school in Nepal. Photo: Tom Price/Tearfund

From: Communicable diseases – Footsteps 112

How to reduce the spread and impact of diseases that pass from person to person

Fear and anxiety about any disease can be overwhelming and cause strong emotional reactions. This is particularly the case when the disease is highly infectious and has the potential to cause significant loss of life.

The fact that the virus, bacteria or other organism causing the disease cannot be seen often increases the level of fear, especially if the disease is new and not fully understood. In addition, measures put in place to reduce the spread of the disease, such as requiring people to stay at home, can cause financial hardship, loneliness and family conflict.

Understanding the pattern

With any disaster, including pandemics such as Covid-19, a similar psychological and social pattern often emerges. This pattern can help us understand how best to support ourselves and others during periods of extreme stress or trauma.

A graph showing the psychological response to a disaster.

Adapted from Zunin, LM & Myers, D (2000) Training manual for human service workers in major disasters (2nd edition). Center for Mental Health Services, Washington, DC, USA.

1. Pre-disaster

Disasters vary in the amount of warning communities receive before they occur. This may be a time of fear and uncertainty as communities wait to see what will happen in their location.

2. Impact

In any crisis, people often respond initially with shock, confusion and disbelief. Their focus is on the survival and physical well-being of themselves and their loved ones. They may experience a level of fear that can cause irrational behaviour.

3. Heroic

During this phase, some people become very busy responding to the crisis and helping others. While activity levels may be high, the actual amount achieved may be low because of a lack of focus.

4. Community cohesion

People gradually begin to work together more effectively and formal government and volunteer assistance may also become available. Community bonding occurs as a result of the shared experience and the giving and receiving of support.

5. Disillusionment

Over time, people are likely to become physically and emotionally exhausted because of multiple pressures. They may have difficulties sleeping, struggle to concentrate or adopt unhealthy coping strategies such as the use of alcohol or drugs. People very active at the beginning of the crisis may tire more quickly and need additional support.

6. Reconstruction

Eventually the crisis starts to ease and reconstruction can begin. A pandemic such as Covid-19 may cause profound, life-changing losses, but it also provides an opportunity for people, communities and societies to recognise their strengths and re-examine their priorities.

Psychological resilience, social support and financial resources influence the ability of individuals and communities to move through the phases described above. In any society some people will need more help than others.

What happens when
we get stressed?

During our day-to-day lives, we experience a range of highs and lows. However, if our level of stress remains inside what is sometimes called our ‘window of tolerance’, we will be able to cope with our experiences as they happen (see box).

A graph showing the window of tolerance.

However, when the stress we are experiencing becomes too much or goes on for too long, we can begin to find that our ups and downs become more extreme.

At one extreme, we may find ourselves becoming anxious or even aggressive. This is part of the ‘fight or flight’ response of our brains to a crisis. It is a natural response, designed to keep us safe if we encounter a threat such as a dangerous wild animal. At the other end of the scale, the stress we are experiencing may cause us to become disconnected, numb or depressed.

How we respond to stress will depend to a certain extent on our personalities. Some people are naturally more resilient than others. Previous experiences – good and bad – will also have an impact on how we respond. If we can begin to recognise when our emotions are either too high or too low, we can then use coping strategies to help us function normally again.

Coping strategies

These can be divided into spiritual, physical, emotional and mental.

Spiritual strategies

Having a sense of meaning, hope and trust in God can help us to cope with difficult circumstances. Spiritual disciplines such as prayer, forgiveness and Bible study enhance well-being. Belonging to a church provides both spiritual and social support. It is good to remember that throughout Jesus’ ministry the busier he got, and the more people crowded round him, the more time he made for quiet prayer on his own.

Physical strategies

Maintaining physical health through regular exercise and healthy eating is very important. Drinking too much alcohol or taking drugs can help relieve stress in the short term, but in the longer term they will make the situation worse. The best way to develop healthy habits is to set small, easily achievable goals. For example, taking a short walk each day. Every success results in feelings of achievement, increasing our resolve to make bigger changes next time.

Mental strategies

When normal routines are no longer possible, it is important to create new ones. These may include exercise, prayer and specific times for resting, eating and sleeping. These routines can be flexible, but it is good to maintain a sense of daily and weekly rhythm, without trying to do too much.

During a time of national or international crisis it is good to be informed, but too much news can be overwhelming. False or misleading information may also be circulating, particularly on social media. Depending on the circumstances, it may be better to access a trusted source of news, just once or twice a day.

Emotional strategies

When we experience a high level of stress we may feel that we are unable to control our emotions and reactions. When this happens it is very important to stop and notice what is going on in our minds and bodies. We can then begin to understand ourselves better, helping us to make wise choices about how best to respond.

Questions to ask are:

Sometimes we can be reluctant to tell people how we are feeling. But there is something very powerful about talking through a problem and being honest about our vulnerabilities.

Know when to ask for help

There are many things we can do to support ourselves and each other through difficult times. However, there may be situations when professional or medical help is needed: for example, if we are threatened, abused, struggling with addiction or are feeling too traumatised to cope.

We are always changed by adversity – sometimes positively and sometimes negatively. The challenge is understanding how we have changed. We can then work out how best to move forward, based on this knowledge.

Adapted from a webinar delivered by Mark Snelling

Mark Snelling is a counsellor and psychotherapist based in London, UK. Prior to training as a therapist, he spent many years working as an International Red Cross delegate. He now specialises in supporting people who work in traumatic environments around the world.

Email: mark@marksnelling.co.uk

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