How To Raise Our Psychological Immunity During COVID-19 

Doctor of Clinical Psychology By Perpetua Neo, DClinPsy
Doctor of Clinical Psychology
Perpetua Neo, DClinPsy, is a psychologist and executive coach who received her clinical psychology doctorate from University College London. She has been featured in Elle, Forbes, Business Insider, and elsewhere.
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I've been watching COVID-19 develop from Singapore since January. We've seen quarantines, panic buying, and general paranoia across Asia. However, my COVID-19 anxiety has been at a consistent low of 1/10. 

Here's the context. I'm not a "just chill" type of person. I identify not just as a Type A personality—impatient, perfectionist, somewhat anxious about certain issues—but as Type A+++. This month, I've been in and out of public hospitals almost every day, due to responsibilities, and I attribute my low anxiety to a general confidence in my government, hygiene-related habits, immune system, community, and the future. 

As the wave hits America, Australia, and Europe, of which some countries have been adamant against testing or generally under-resourced, I've been speaking to my friends and clients about their anxieties. And here's what I want you to know about raising psychological immunity because our immune systems and bodies are compromised by excessive stress or the inability to handle stress.

This is not about delusional naïveté. COVID-19 has killed and/or debilitated many. Psychological immunity is being realistic about what's happening and partnering with reality to establish a sense of control the best we can.

It's easy to disregard stress as "It's all in your head," evidenced by platitudes like "Just think positive!" The truth is, it's not all in your head, but your mind can make everything worse. What most people fail to realize, though, is your mind can also save you.

Here's a series of questions to reflect upon, about your current psychological immunity, and how to strengthen it:

1. Am I confident about my hygiene-related behaviors? 

Last year, two friends and I were animatedly discussing our hygiene-related behaviors, feeling like we'd finally found people who got one another. Looking back, these behaviors increase my confidence about limiting my risk of contracting COVID-19. Let's break them down:

  • Washing hands properly and regularly: Kills way more pathogens than any sanitizer.
  • Using the right kind of sanitizer: 70% isopropyl is the sweet spot; 90% means too little water for it to be effective.
  • Cleaning your phone and keyboard every day: They pick up a lot of pathogens.
  • Not using your phone in the bathroom or putting your dirty phone on your bed; not putting your handbag on the bathroom floor and then on the dining table; removing your rings before using the bathroom.
  • Disinfecting luggage before bringing it indoors; double-bagging your shoes before putting them in luggage.
  • Not wearing shoes indoors; cleaning your feet before entering the house.
  • Not touching your face or eyes, and instead touching somewhere else like your arms.

If you're not confident about your hygiene-related behaviors, then you could use the pandemic as an opportunity to develop them—they shouldn't only be practiced during times of health crises. 

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2. Am I confident about my biological immune system?

Up until three years ago, my fevers persisted on and off for about two weeks. Historically, I've never been robust, struggling to run less than a mile without panting. Today, I run more than 3 miles nonstop, confidently scale rocks, and my fevers only last two days. 

This is the result of baby steps—strength training, endurance, and taking care of my body with intermittent fasting, respiratory muscle training, and eating a sugar-free vegan diet twice a week. I also use essential oils and sneak raw garlic into homemade pesto for a further boost. As an unabashed glutton, I love meat and sweets, but balancing these out with discipline pays off.

In this time of push toward social distancing, you can instead learn to cook healthier meals, run outside, or workout indoors with online classes.

3. Am I confident in my community?

First, here's what's not helpful for communities:

  1. Racism: I lived in England for 10 years and can attest firsthand that racism is terrifying and traumatic. The video of bat soup wasn't even filmed in China; calling it the Wuhan virus fuels xenophobia; so is beating someone up for being Chinese
  2. Panic buying: Lower-income individuals lack the financial means to stock up. It can also affect the elderly, who are the most vulnerable to COVID-19. When we clear the shelves, we make it harder for these groups to access necessities.
  3. Insulting people who panic buy: Moral grandstanding about how "stupid" or "Third World mentality" those who panic buy are isn't helpful. It just alienates. The truth is, stockpiling can create a sense of control and certainty. It's a universal human behavior, albeit one we can transcend. 

Next, here's what you can do to be a useful member of your community, as offered by my colleague Mandeep Ranger, DClinPsy:

  1. If you see anyone bullying someone for being Asian, stand up for them.
  2. Organize people to keep an eye on the vulnerable (elderly, ill, disabled, without social support) if they have to isolate or have no way of getting the basics.
  3. Ranger shares that "isolating oneself may be OK for some who have support but not for those who cannot," and practical support measures will limit them from having to go out into places to where they are likelier to contract the virus. Also, "Offering help may seem labour-intensive at first and put you close to someone who has the virus. But surely it is better to know as you can limit the unmonitored spread, which will then be harder to contain. And as COVID-19 peaks and takes over health services, other illnesses and care needs are likely to get pushed back. Volunteers and community support can negate this issue, allowing front-line staff to focus on combating the main health needs."
  4. Be kind to medical staff and thank them by their name. It's a hassle to be screened consistently (if your country practices this), but be kind to these individuals rather than taking your frustrations out on them. Moreover, with these extra jobs created, it helps the economy. Bottom line: It helps us all.

And it's with this that Mr. Rogers' words come to mind. "When I was a boy and I would see scary things in the news, my mother would say to me, 'Look for the helpers. You will always find people who are helping.'" In uncertain times, we can get more alienated. Or we can become stronger together. 

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4. Am I at the mercy of my mind?

The way we perceive something and how we then choose to cope are called mental adjustment styles. They include:

  • fighting spirit
  • helpless/hopeless
  • anxious preoccupation
  • fatalism
  • avoidance

A fighting spirit entails an optimistic attitude and a realistic appraisal of the situation and is linked to best outcomes in cancer, HIV, and end-stage renal disease; while feeling helpless and/or hopeless is linked to the worst outcomes. 

In 2013, I ran a global study on 202 individuals at management level and above who'd lost their jobs and found that the anxious preoccupation style was linked to highest distress and worst outcomes. 

Whether it's loss or physical illness, our mindsets matter. Being in control starts with knowing this is how we're wired to survive:

  • We remember negative events more than positive ones.
  • Our brains look out for threats.
  • If we're constantly worried, we notice more threats than what really exists.
  • Our brains cannot discriminate between actual and imagined threats.
  • Emotional and social threats are painful; feeling the pain doesn't mean we're weak.
  • What this means is, there's no shame in saying that there are things that make you anxious.

Here's what you can do next that works for all my clients, from 5-year-old children to middle-aged CEOs to 70-year-old retirees:

  • Acknowledge you're anxious. Simply say, "I feel anxious," or say, "I see you" to your anxiety.
  • Ground yourself by shuffling your feet, feeling the points of contact between your soles and the ground. We make the wisest decisions when we're in our bodies rather than lost in our heads
  • Do a three-breath exercise to reset your brain's fear center or help regulate your nervous system.
  • Do something to take care of yourself.
  • Practice daily routines that create a sense of certainty, something that's reliable that anchors you. Stay away from media sources or people that fuel your anxiety because when anxious, we unwittingly believe we need to feed anxiety.
  • If the coronavirus is exacerbating other anxieties and past traumas, then you might consider working with a trained profession online so you have a sense of peace. Mastering anxiety is really about weeding out the root and designing a new lifestyle rather than merely piling on the proverbial Band-Aids of distractions and denial.
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5. Can I weed out the misinformation? 

What we believe to be facts can be hypnotic. There's plenty of misinformation about COVID-19 that have sent us into a frenzy globally, such as why we fear a toilet paper shortage. Before accepting everything you're told, remember, you have the power to fact-check. Here are some great basics:

  • This TED talk by a global health expert on COVID-19 101.
  • What to do when you have symptoms.
  • The facts about wearing masks—why you should keep supplies for those who need it and why disposing responsibly is even more important. 
  • Checking reliable sources like the CDC and the WHO.

6. Do I have faith in the world I'll return into?

COVID-19 has changed our world. We can lose ourselves down the rabbit hole of hopelessness and fatalism, or choose to partner with reality, turning this into an opportunity to redesign a world we want to return to.

As it is, many of our personal and professional practices have been cobbled together as a reaction to whatever's happened, or blindly adopted. Even if unsustainable, we've carried on unquestioningly. The COVID-19 pandemic is a time to choose what we want to keep and to add. 

There's a real life we have to return to, eventually. We have a stake in creating that world. Cycles of health and disease—like recessions and prosperity—are part of life. What works best is that we prepare. 

To quote Taoist philosopher Deng Ming-Dao, "So many people bemoan bad luck. Bad luck comes to everyone, but misfortune is not an automatic condemnation. It can't be eradicated, but it can be avoided. If you have to face bad luck, the next best thing is to keep calm and focused. The worst mistakes are to compound our problem by missing opportunities, being so rattled that we make more mistakes, or being so distracted that we don't notice another worse danger heading our way."

COVID-19 won't be the last pandemic we face. The least we can do is raise our psychological immunity, personally and collectively.

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