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Coronavirus and me: out of control?

Ian Wootton, Head of Psychology and Consultant Forensic and Clinical Psychologist at Priory Group’s Stockton Hall Hospital, has looked at how people with an overcontrolled coping style have been impacted by the changes and uncertainties caused by the coronavirus outbreak.

Ian has also outlined the ‘body-to-brain’ techniques that people with this coping style can use to help them better deal with the adjustments that have been made to their day-to-day life.

Rewind to 16th November 2019 and imagine someone telling you that the first case of a deadly virus would be found the very next day and that the virus would then spread across the world, resulting in everyone in society having to enter ‘lock down’ for over three months. 

How would you feel? 

Most people would feel shocked and even panicked by the news, but for some, it would be particularly difficult to contemplate and cope with.

How have we coped with the changes caused by coronavirus?

People usually have one of two overarching coping styles, which are known as ‘undercontrol’ and ‘overcontrol’. Every person at least ‘leans’ towards one of the two coping styles, but they may not do so to an excessive level.

While the societal changes caused by the coronavirus have been challenging for everyone, it could be said that they have been especially unforgiving for the people with an overcontrolled coping style. People with this coping style can have an excessive level of self-control. They are serious about life, set high standard for themselves and work hard, but struggle with things such as flexibility.

Many people in society have this excessive style of control. It is also often present in people with mental health conditions such as obsessive compulsive disorder (OCD), as well as paranoid and avoidant personality disorders.

People with an overcontrolled coping style will typically:

  • Comply with the expectations of society
  • Set goals and rigidly come up with strategies to stick to them
  • Not like to make a fuss, regardless of whether they are experiencing success or a problem

There are several drawbacks associated with this coping style, which include:

  • Low receptivity and openness – low openness to unexpected feedback, the tendency to avoid uncertainty or unplanned risks, and hypersensitivity to threats
  • Low flexible control – a compulsive need for structure and order, and high levels of planning
  • Emotional suppression and inhibition – a lack of insight into their emotional experiences and the ‘masking’ of emotions
  • Low social connectedness and intimacy with others – aloof and distant relationships

People with this coping style are likely to have found it more difficult than others to deal with the changes and various measures that have been imposed to contain the spread of the coronavirus, which do require elements of flexibility.

Efforts that have been utilised to try and control the coronavirus outbreak have included suspending numerous structures and processes; imposing and revising new rules and expectations; and, restricting our social interactions. Adapting to these new routines, implementing new ways of working, and relinquishing many of the things that make us feel safe, secure and in control will have been extremely challenging for people with an overcontrolled coping style.

Support for people with overcontrolled coping styles

Professor Lynch, who conceptualised the idea of ‘undercontrol’ and ‘overcontrol’, developed a programme known as radically open dialectical behaviour therapy (RO DBT), which is used to help people who have an overcontrolled coping style.

RO DBT promotes the value of seeking pleasure, relaxing control, and joining with others. It is not based upon the idea of regaining control, but on the idea of ‘flexible responding’, where a person does what is needed in the moment to manage the situation or adapt to changing circumstances.

The techniques that are taught within RO DBT can be useful to people with excessive self-control who are struggling during this pandemic, as they ‘turn on’ our social safety system so that we feel safe and connected, and de-activate the threat system to help us calm and soothe ourselves. 

Examples of the ‘body-to-brain’ techniques used in RO DBT include:

  • Lean back in your chair, take a slow deep breath, making a closed-mouth ‘co-operative’ smile, and raising your eyebrows – leaning back informs the brain that “I’m relaxed”, and a deep breath stimulates the diaphragm, which can indicate to the brain that you are in restful state. The closed-mouth smile activates facial muscles, particularly the orbicularis oculi around the eyes which is a characteristic of a genuine smile of pleasure; and raising the eyebrows universally signals affection and liking
  • Participate in loving-kindness meditation – sitting or lying down, bringing awareness to your breath and body for a moment, and then extending thoughts of warmth, kindness and love towards other people can lead to a positive mood, which is associated with safety and contentment. It can also increase feelings of warmth and care for yourself and for others
  • Tense, release and stretch your facial muscles - the stimulation of the facial muscles signals to the brain the message “I am not trying to mask my inner feelings” and, therefore, that all must be well
  • Use wide, expansive arm and body gestures and movements - large arm and body movements are interpreted by the brain as symbolic of openness and expression, and are taken as evidence that there are no threats present
  • Use touch, deep pressure, massage and hugs - body sensations linked to physical closeness and touch are universally experienced as comforting, as they relate to a sense of belonging and community, and therefore safety
  • Chew and eat food - chewing naturally calms the body as it moves the facial muscles that are linked to social safety, and has also been shown to facilitate memory and to reduce stress. Furthermore, swallowing is associated with rest and digestion, which does not occur effectively when a person is upset
  • Listen to human speech or vocal music - the human voice has a calming effect as the muscles of the inner ear that allow us to hear speech effectively are linked to the ventral vagal complex, which can help a person feel safe and therefore rested and relaxed. Music can also modulate activity in emotion-processing areas of the brain
  • Breathe more deeply; using long, slow exhalations - abdominal breathing stimulates the diaphragm, which is responsible for relaxed breathing when resting, and therefore is effective at reducing strong emotions
  • View pictures that are linked with warmth, expansion and peace – this can help you to enter a positive mood, which is associated with safety and contentment
  • Tense and relax large muscle groups - the relaxed state of the muscle groups signals to the brain that the body is no longer tense and, therefore, that you are in a position of safety

These techniques can help a person with an overcontrolled coping style to relinquish the sense of control that would, otherwise, keep them ‘stuck’. 

It can make changing routines, amending plans and engaging in novel behaviours less of a challenge for someone with excessive self-control, helping them to tolerate the uncertainty that is present at this time and to work through the challenging situations that they currently face. 

References:

  • Clark, L. A. (2005). Temperament as a unifying basis for personality and psychopathology. Journal of Abnormal Psychology, 114(4), 505-521.
  • Coid, J., Yang, M., Tyrer, P., Roberts, A., & Ullrich, S. (2006). Prevalence and correlates of personality disorder in Great Britain. British Journal of Psychiatry, 188(5), 423-431.
  • Jiang, M. (2020). The reason Zoom calls drain your energy. https://www.bbc.com/worklife/article/20200421-why-zoom-video-chats-are-so-exhausting?
  • Kendler, K. S., Prescott, C. A., Myers, J., & Neale, M. C. (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry, 60(9), 929-937.
  • Krueger, R. F., Caspi, A., Moffitt, T. E., & Silva, P. A. (1998). The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107(2), 216-227

 

Blog reviewed by Ian Wootton (CPsychol AFBPsS), Head of Psychology and Consultant Forensic and Clinical Psychologist at Priory Group’s Stockton Hall Hospital

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