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March 26, 2020
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By Allen R. Miller, PhD, MBA

The absence of consistent and reliable information about the coronavirus seems to be increasing people’s anxiety. They often think, “I don’t know what to do”;  “Am I doing the right thing”; and “What else should I be doing?” No wonder they feel confused and overwhelmed. Cognitive Behavior Therapy (CBT) is uniquely suited to help people gain control of their lives and feel better.

Public health officials have given us directions to maintain physical distance from others, wash our hands for 20 seconds, and disinfect our surroundings. While many people are following those directions, some are not. Following these directives doesn’t necessarily alleviate people’s fears about what comes next, though. Indeed, there is a lot of uncertainty. We don’t know the path of the virus nor its longevity. The destruction that has already been done by the virus doesn’t seem to be the full measure of its toll. We have seen people react to the pandemic by trying to gain control of their lives and surroundings. It is the effort to gain excessive control that leads to constant checking and sometimes hoarding of crucial medical supplies.

Paradoxically, the more we try to control everything in our environments, the less control we feel. The infinite number of possible actions is greater than we can calculate, let alone act upon. We need to do what we reasonably can to manage ourselves and our surroundings and ultimately, we need to get comfortable with the idea that we don’t have control.  

What is the cost of the relentless pursuit of control? Observable behaviors like bulk purchasing and excessive cleaning are the tip of the iceberg. Underlying these behaviors are a range of negative thoughts and painful emotions. CBT tells us that excessive attempts to control are associated with thoughts such as “I am vulnerable,” and assumptions that “If I don’t overprepare, then I will fall victim.” When we think this way, we feel fear and irritability. When thoughts, emotions and behaviors are aligned in this way, a repetitive cycle begins based on the belief  “There is danger and whatever I do is inadequate.” This is the underlying explanation for why trying to gain control only leads individuals to feel less in control.

How do you give up control and how does giving up control help you to feel better? CBT uses a scientific approach to answer these questions. First, question yourself about what sounds reasonable and is founded in scientific evidence. For instance, “Does it make sense and is there evidence to support the effectiveness of recommendations such as social distancing, hand washing, and keeping your hands away from your face?” Alternatively, “Does it make sense and is there evidence to suggest that repeatedly scrubbing your hands for more than 20 seconds will reduce the likelihood of contracting the virus?” Most people conclude that the first question is answered affirmatively and that the second question is not. Listening to public health officials and saying, “I have done everything that is reasonably possible” is a step that illustrates that one is shifting the focus from listening to fear-related thoughts such as “I am in danger” to more realistic thoughts such as “I have followed the recommendations of the scientists who know more about the virus that I do.”

The next step can be a difficult one. Unfortunately, doing everything that we possibly can do does not give us absolute control over the virus, or even our immediate surroundings. Even on a good day, we as individuals don’t control the world. Whether it’s good things that happen to us on a daily basis or a global pandemic, we don’t sit in the driver’s seat. In spite of the actions we take, we don’t control much about our surroundings. This step is accepting at a deep level that we don’t have control. In situations when we don’t get what we want, or worse, that we get what we don’t want, we may feel hurt and angry.

If we give up control, where does that leave us? Well, most of us are left at home isolated from people we know and deprived of activities we like. This is a perfect time to reflect on things we truly value and what is important to us. This is a very individual matter. People may value being productive, providing for their families, spirituality, relationships, activities, the arts, sports, or something else. Which of these that we as individuals value is not the important thing, although we may reassess what we think is important at a time like this.   

When we have identified what we value and what is important to us, we are uniquely empowered to pursue those things. CBT tells us that acting according to our values will help us feel better and improve our self-efficacy. We have empowered ourselves to act on those things we have determined are most important to us. By doing so, we give ourselves control. Control— the thing we have wanted all along— is now ours. As we move along this path, it is essential that we keep in mind what we value. What we do and how we do it will be meaningful and have purpose for us when we remind ourselves that we are pursuing our own aspirations.

We can use CBT to reduce our fears, conquer overwhelmed feelings, change our thinking and act in meaningful ways.