Written by Dr Kate Beaven-Marks
How many hours a day do we spend being bombarded with health information? Now more than any other time, people are getting illness and death warnings whichever way they turn. Not just social media, but the mainstream news and even down at the corner shop! Every scratchy throat, sniffly nose or, horror of horrors, a couple of coughs, can lead someone to worry that it might be something more significant.
Sadly, the fear of becoming ill can have a significant effect on someone’s daily life and a negative impact on their immune system. Leading to them becoming more vulnerable to illness. At the present time, not only are some people developing a fear of developing Coronavirus, but also of circulating in public where the virus may be present.
Throughout lockdown and the variations since, many people have experienced intense emotional responses, including anxiety, panic, depression and fear. The fear of becoming ill, the fear of contact with others, even the fear or being ill and unable to receive adequate care. Some have experienced irrational thoughts or behaviours in other ways, such as a need to hoard or over-prepare for any eventuality to compensate for almost overwhelming insecurity. Every age group can be affected. From children not understanding changes to routine, to older people missing essential contact and care and who may have less internet accessibility than other adults.
This blog is going to explore some key health anxiety issues that have arisen in the past year and relates those to Maslow’ Hierarchy of Needs.
At the start of lockdown and during the first few months, some people were unable to get the food or medicine they needed. If you consider this is terms of Maslow’s Hierarchy of Needs, people were struggling to get what they needed (remember the shortage of toilet paper, baby milk, pasta, flour and paracetamol) on a fundamental (physiological needs) basis.
There were also issues of hoarding, where people would buy masses more than they needed, and this could be in response to their safety needs (see diagram above). In addition, with so many differing opinions, people were unable to feel psychologically safe. As well as these fundamental needs, the lockdown and drastic isolation had an impact on a deep level affecting how people met (or, were unable to meet) and the effect on their relationships and their connectedness needs.
Moving through the chart, higher needs are also influenced, with some clients feeling as though are still ‘on pause’ and they have achieved nothing since March 2020; it is as though the past year has gone past without anything positive to show for it. This then can have an impact on the highest point on the hierarchy, that of self-actualisation and achieving one’s fullest potential. Some clients are ‘beating themselves up’ over how they have coped, or are coping, and finding that they have not lived up to their own expectations. This then leads into a host of negative emotions include anger, guilt, loss, shame and depression.
Isolation and loneliness
Many people report that in recent months, it is the impact on relationships (connectedness needs) that has been the most significant challenge. Interestingly, even people who are living with others can report feelings of isolation and loneliness. Loneliness is a state of mind, of perception of connectedness, rather than location, and someone can experience it even when surrounded by people, whether they know them (e.g., family) or they are strangers.
Loneliness, from time to time, is a normal aspect of human life and can be experienced as reactive loneliness (e.g., after a divorce). Where a client doesn’t have the financial, emotional or mental ability (or at present time, societal ability), to meet their social needs and engage in social circles and interaction, then such loneliness can become chronic and lead to negative health consequences.
Social isolation and loneliness can have effects on all aspects, (cognitive, mental and physical) of someone’s health. People commonly report increased levels of stress, sleep disturbances, weight and diet effects and increased impact of anxiety and depression. Indeed, Professor Julianne Holt-Lunstad, in her paper found that where there is both isolation and loneliness, there was a 32% increased likelihood of premature mortality, and that when combined, can be twice as harmful to mental and physical health as obesity!
Information and misinformation
Though a superb tool in helping to keep isolated individuals connected, the internet can also have an unhelpful effect on fear levels, affecting at a safety needs level on the hierarchy. People can struggle to sift though and weigh up the validity of the immense amount of information and misinformation available on the internet and in particular, on social media platforms.
Fear of going out/resuming life
Simply attempting to go back to an old routine can be a new cause of anxiety. Things will have changed. Whether that is our journey to work, our work place or even how we walk around our local supermarket (queues, one-way systems). Individuals already struggling with social skills and conventions may find it particularly difficult to navigate the new expectations of being out in society, such as social distancing, ‘place and step back’, wearing masks/disposing of masks, when to sanitise/when to wash hands (what do you sanitise and when?), even how to use contactless card readers.
After a while there can be an adjustment to one’s world view and our home can be perceived as a safe zone. Some will sanitise everything (and everyone) that crosses the threshold and have a profound fear of the risk of infection. This can result in a reluctance to leave the home and venture outside into what is perceived as ‘infected’ space thus having an impact both at a physiological needs and a safety needs level.
Lack of effective routine
One of the most challenging aspects of lockdown isolation and quarantine is the impact it has on long-established (even lifelong) routines. Whilst some people relish change, for others, when it is inflicted upon them, they feel disempowered and vulnerable. Referring back to the lower aspects of Maslow’s Hierarchy, if someone cannot shop for food and medicine in the way they usually have, they can worry about their survival. This isn’t something most people have had to consider before. For others it is all too familiar. PTSD can be triggered in those who have experienced social restrictions in places of conflict prior to living in the UK.
Prior to the virus emerging in the UK, there was little to stop people going about their lives on a day-to-day basis, perhaps going to work, shopping, socialising, seeing loved ones and so forth. Now, all of that has changed. There can seem to be no end point either. The uncertainty can be an added level of disturbance, as new ‘permanent’ routines cannot be established, people are held in a state of temporariness. Rather than simply lamenting the loss of old routines, it can help to establish new routines. Totally accepting that they may change, but doing what helps ‘for now’.
Emotional overwhelm and poor emotional regulation
Many people are accustomed to feeling occasionally anxious or stressed or fearful. Yet not all will have the inner resources and coping strategies to deal with being exposed to these emotions on a prolonged basis leading to a feeling of being overwhelmed with such emotions. People can feel anxious, on edge, restless, irritable or unable to concentrate, over-stimulated in an unhelpful way and not able to employ any self-soothing tools. Alternatively, they may simply shut down those raised levels of disturbance by locking down their feelings so thoroughly they have a lack of interest and a lack of energy to engage in anything.
As people adapt and perhaps work through initial emotions, as the acute phase of change became established, there can be a transition into new range of negative emotions. Some people have naturally taken the new ways of living in their stride. They may not like them, but have the flexibility to adapt. Others, who are more rigid in their belief systems, may run out of patience. Finding that they were waiting for that simple meet up with friends and then the rules change and it, again, looks like months before that could happen. This can lead to feelings of frustration, anger and resentment. Left unaddressed, it can be explosive, if expressed outwardly, or, if contained within, can have a damaging effect on mental and physical health.
Hypnotherapy solutions – what can help?
As with any health anxiety client, a thorough intake (consultation) will help ascertain their specific concerns and goals. There are no specific ‘scripts’ to use to help clients through their experience of lockdown and subsequent restrictions to their liberty and daily life. Rather it is worth considering what aspects of their life they feel are lacking and helping clients connect to appropriate solutions. Aiming to respond to and meet each aspect of Maslow’s Hierarchy of Needs can offer useful guidance. This will likely engage a wide range of your usual approaches, helping people develop new routines (behavioural), change limiting beliefs to resourceful beliefs (cognitive), gaining insight into their underlying responses, needs and desires (analytical), as well as connecting to past events and resources (regression). One of the key areas you may find touches each and every session will be ego strengthening, working to develop and strengthen resilience, boost coping strategies and help clients to self-soothe.
In terms of suggesting strategies for self-care, a practical and solution-focused approach of ‘doing’ something, rather than ‘not doing’ something, can help people feel more empowered and reduce anxiety. This can include,
- Taking a rational and solution-focused approach to worries and concerns
- Creating new routines
- Staying connected
- Eating well (nutritious food)
- Taking exercise
By addressing specific concerns and working to develop your client’s resources and boost resilience, together with practical approaches towards self-care, you will find that you are able to address not only their present concerns but also help them develop coping strategies to more comfortably face any new challenges positively.
Want more information about how to help this kind of client? Join one of our upcoming free hypnotherapy training events to learn more about training as a professional hypnotherapist, and how to learn all the approaches that you would need in order to work with this type of client.
We hope you enjoyed this blog on understanding health-related anxiety with Maslow’s Hierarchy of Needs. If you have any questions about this topic or anything else for that matter, do please get in touch, because we’re always happy to help!
– written by Dr Kate Beaven-Marks