Uncomfortable as it may make us, there is very little solid ground in life, very little of which we can be 100% certain. That is the bad news. The better news is that certainty is not actually required for peace of mind. In fact, much of what happens along the way in behaviorally oriented psychotherapy is learning how to keep yourself actively moving in the desired directions in the face of perpetual uncertainty.
For people working to improve their mental health – be it symptoms of anxiety, depression, or eating disorders – the road to recovery gets paved by welcoming the unknown and uncertain, leaning into challenges, even (and especially!) when it’s hard, and using what is learned to adapt to the next challenge. This strikes me as something the pandemic is forcing us all to work on to stay afloat through each new pandemic wave. Healthy coping often means doing – making choices consistent with emotional wellbeing – even though there is discomfort, fear, or sadness. Learning to lead with behavior – flexible, adaptive behavior – is key.
When I had COVID a few months back, the ‘healthy doing’ took several forms. I was disappointed to be unable to host a large family dinner I had planned, testing positive the day before. In the face of that disappointment, I moved the food I had prepared into the freezer for a future gathering. I facetimed with family instead. I worked from home in the morning while I felt well, but canceled afternoon meetings to nap or simply lay on the couch feeling lousy. I dropped out of a race I’d signed up and trained for because it was taking place when I was newly recovered; instead, on race day morning, I took a long walk with a friend to ease my body back into exercise safely.
For my patients, flexibility in the face of uncertainty has taken different forms with the ebb and flow of pandemic tides.
Take Jordan*, for example. He is a young man with poor body image, who worried each time he walked into a room that others were judging him for his size as harshly and as frequently as he judged himself. He weighed himself daily and tried to explain every fluctuation on the scale by scrutinizing a calorie-tracking app, often undereating early in the day and binge eating by the late afternoon. At the start of the pandemic, his challenges included being confronted by his image all day on Zoom calls and working steps away from his kitchen; there was relief in the social isolation and the acceptability of wearing athleisure clothes instead of his more fitted work wardrobe. More recently, his hybrid work setup has meant a return to the office and to in-person interactions and meals.
The key to health for him, his ‘healthy doing,’ has included deleting the calorie-tracking app and limiting himself to once weekly weight checks. On remote work days, he sets himself up in his bedroom with the door closed to reduce unplanned eating and uses alarm reminders for meal and snack times. On in-person work days, he goes out for lunch with his team and eats well regardless of the assumptions his mind is making about others’ perceptions of his appearance. He sticks to the first work outfit he’s selected, no matter how he feels about his body that day. He is learning that doing different is a more surefire way towards the life he wants, rather than avoidance of discomfort at all costs.
We cannot escape the ongoing stress of the pandemic, or other stressors soon to come our way. Psychological flexibility is about acknowledging the shifting tides, and making room for the unsteadiness (distress, disappointment, worry, and uncertainty), all the while acting in the service of what we decide is most important to us. Jordan is not thinking as much about his weight or appearance these days; he is enjoying improved involvement at work and connection with others. Despite the tough stuff, there can be big rewards and clear benefits when we get ourselves to do the doing, to find our balance no matter how big the wave.
*Jordan is a fictionalized composite patient.
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