Our emotional health and that of our patients has taken a terrible beating at the hands of the COVID-19 pandemic. Suicides, substance abuse, levels of depression, and anxiety have risen dramatically. It is tempting to believe that it is the unfortunate events alone we hear about and experience that are causing us to feel the way we do. However, James Gross, PhD, professor of psychology and director of the Stanford (Calif.) University psychophysiology laboratory said: “It is actually the thoughts that we have about the situation that are leading us to feel negative emotions or fail to feel positive emotions.” (YouTube video – https://www.youtube.com/watch?v=Ay4_L1RfkIs).
Dr. William G. Wilkoff
With this premise as a jumping off point, a large group of psychophysiologists at a variety of centers around the world began a study of more than 20,000 subjects in more than 87 countries and regions. Half of the subjects were exposed to a brief (about 5 min) emotional regulation strategy called “reappraisal.” All the subjects were then shown images of the COVID-19 crisis culled from news sources and were then surveyed about their emotions. The researchers discovered that those subjects exposed to the reappraisal intervention demonstrated significantly increased positive responses and significantly decreased negative responses compared to the two control groups.
Reappraisal is an intervention that encourages individuals to think differently about their current situation in hopes of improving their emotional responses. The researchers tested two different types of reappraisal: “Reconstruing,” which aims to change the way the situation is represented mentally – for example, viewing it as controllable – and “repurposing,” in which the subject is encouraged to focus on the potentially positive outcomes of the situation. In other words, reappraisal basically tries to instill a glass-half-full, silver-lining mindset. The investigators report that both reappraisal strategies were equally effective at influencing the subjects’ responses.
The authors claimed that their findings suggest that reappraisal interventions might be of value for health care and other essential workers who have demonstrated a vulnerability to emotion upheaval during the pandemic. The authors also envisioned opportunities for political and business leaders to implement national and global reappraisal–based initiatives to generate resilience on a national and even global scale.
I will admit that, although I am usually skeptical of studies aimed at quantifying emotions, I found this study interesting. After watching a half hour of television news or reading the online edition of the New York Times I think we could all use a pep talk from someone who might be able to help us look on the bright side of things. However, I doubt that a single 5-minute reappraisal intervention is going to have much lasting benefit in the face of the shear magnitude of bad news we are fed every day. Catastrophic news sells newspapers and it is unlikely that dynamic is ever going to change.
I guess we could try mandating that every half hour of network news be followed by a 5-minute session of reconstruing or repurposing. That is, if we could find someone who could consistently put a positive spin on the news of the day. Even if we could locate that one-in-a-million individual with an absolutely unshakably sunny disposition and a knack for finding silver linings, I suspect after a few weeks he or she would be labeled the arch Pollyanna and be drummed off the air.
That is not to say that we should write off the findings of this international study as a statistical quirk. It may be, but clearly these last 2 years have taken a toll on our emotions and even those of us who are congenital optimists need a pep talk from time to time. Although my forte is denial, I think I already know how to reconstrue and repurpose, but I’m ready to listen to anyone who can help me learn to do it better.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at pdnews@mdedge.com.