A web of coronavirus perspectives

As lockdown began, The Psychologist team set to work collecting evidence-based perspectives on coronavirus and the pandemic response for our website. At the time of writing, there are more than 90 views, interviews and more gathered there, from more than 120 psychologists. We are very grateful to all who gave their time and expertise so generously during challenging times.

To dip into what has been variously described as a ‘treasure trove’ and a ‘confusing mess’, see tinyurl.com/psychmagcorona – here, we look to give you a snapshot of what’s on offer, by drawing out some key themes. Some of the pieces not mentioned here have made it into the summer issue in full, and the collection continues to grow by the day…

The public and the science
Social psychologists came to the fore during the crisis. Before lockdown began, Stephen Reicher and John Drury were urging ‘don’t personalise, collectivise’, arguing that coronavirus was ‘a powerful wake-up call. We have to change the way we frame the epidemic. We have to change we see the individual and society. We have to collectivise – or we die.’ Reicher, Drury and Clifford Stott returned to the importance of a community perspective with ‘The truth about panic’, and Chris Cocking responded to the Dominic Cummings affair with a warning that ‘resilience requires those in authority to be honest, open and consistent’. ‘Appeals by politicians for people to “come together” in emergencies need to be backed up with real practical attempts to engender and maintain such collective unity,’ Cocking continued, ‘otherwise it risks becoming empty rhetoric that will simply fall on deaf ears.’    

Psychologists attending the UK government’s Scientific Advisory Group for Emergencies, or its subgroup the Scientific Pandemic Influenza group on Behaviour (SPI-B), talked to us about the challenges inherent in the idea that the response was ‘led by the science’. Brooke Rogers spoke to our journalist Ella Rhodes about how ‘all interventions must stand up to scientific scrutiny’, but towards the end of March Susan Michie was telling us that SPI-B was ‘not currently engaged with the latter parts of the translation process, the written and verbal communication of scientific advice and behavioural advice for the general population. For example, there has been confusion as a result of vague, ambiguous and inconsistent messages, as seen in differences between NHS and Government written guidance and in the interpretation of guidance by different Government ministers. This undermines the likelihood that people will follow the guidance, and can cause anxiety, frustration and resentment.’

Lockdown living
Early on, in a piece that found an unusually large online audience, Nathan Smith and Emma Barrett looked to extreme environments for tips on how to cope with isolation and confinement. Holly Carter and Dale Weston, from Public Health England, spoke to Ella Rhodes about the difference between self- and supported-isolation (away from the home), and why the latter was likely to be particularly stressful. Holly and Dale were back, alongside Clifford Stott and Richard Amlôt, to outline evidence-based strategies to promote adherence to social distancing measures.

Health behaviours were the focus for Emma Davies and James Morris (alcohol consumption during isolation), Sharon Cox (‘now is not the time to afford smoking tacit approval’), and Dominic Conroy and Emily Nicholls (‘how is health behaviour changing, among whom, and will any changes last post-lockdown?). Colm Mulcahy wondered whether habitual behaviours could play an important role in sustainable transport post-lockdown.

Gender was on the agenda for Stephen Blumenthal, finding male clients more willing to open up via remote therapy; and for Terri Apter – would the pandemic be a disaster for feminism? What were the implications for work-life balance, and the shaping of domestic routines? Nancy Schlossberg, a 90-year-old counseling psychologist and retired professor, asked her ‘aging rebels’ about those relationships and routines. ‘This enforced opportunity for individuals to pause, reflect and even to plan, may ultimately amount to a collective focus that will eventually reveal how each of us wants to, and will, live that future’, she concluded.

Also putting a positive spin on affairs was Jennifer Symonds. ‘After lockdown is over, having less time to communicate with family, more distance from local neighbourhoods and communities, a tighter schedule with less flexibility for exercise and fewer hours for reflection, re-exposure to greater levels of pollution, and for some, a return to daily relational conflicts at work, could be key reasons why some people might think back on Covid-19 as being a positive pandemic, as well as a deadly one. Perhaps, adapting back to the ‘new normal’ at the end of the lockdown could be our biggest challenge.’

The frontline
Long before it was added to the official list of symptoms in the UK, Evelina Thunell, Asifa Majid and Johan N. Lundström were considering whether loss of smell is an early diagnostic indicator of Covid-19 – and the role of psychology in determining that. Anita Mehay, Jane Ogden and Rosie Meek were considering why prison conditions can be a perfect storm for spreading disease.

Working with hospital staff, Olivia Sutton spoke to those working on non-Covid wards: ‘I began to get a sense from the interviews that the staff did not see themselves as the ones who needed support, despite sharing their worries rather openly with me.’ Janice Smith spent time ‘listening to [healthcare workers’] anxieties, normalising work-related emotions, some of which they have not felt so far in their career, and “containing” their internal conflicts. As a practitioner of Acceptance and Commitment Therapy for over 10 years, no other approach felt more apt in supporting staff move to a place of acceptance. That is, while staff and the system are doing their best, at times the outcome is not what anyone wants, or can sometimes prevent.’  

Making meaning…
Viktor Frankl’s Man’s Search For Meaning cropped up across a few contributions, including Coralee Pringle-Nelson with a perspective from Canada which considered whether it’s a time for ‘tragic optimism’. Looking to research on purpose, significance and coherence, Rhi Wilmott concluded that we do not know when the pandemic will end, or what life will look like once it does, but ‘perhaps the present uncertainty will give rise to new forms of meaning. When we emerge from the chrysalis of lockdown, this resource will help us greet the world with purpose.’ Erin Beal took a similar slant, arguing that ‘If one positive can come from this incredibly difficult time it is maybe that we can reflect on the areas of our life that we miss the most, the ones that feel most threatened. It may highlight what we hold most dear and the areas of our frameworks that we most want to spend time in when we are allowed to reengage in the ‘new normal’ post lock down.’

Nisha Pushpararajah pondered whether the extent to which a nation adopts a cultural/collectivist mindset could be behind differences in policy and public responses. Sue Shea and Robin Wynyard recalled Leon Festinger’s work on cult members after their prophecies fail. ‘Using the concept of the “day after” to metaphorically describe the “new normal”, we suggest that consideration may need to be given to the adaptation or revision of certain theories to take into account the fact that the “unexpected” can happen, and that there are circumstances where the concept of “control” is simply not within our reach.’

Letticia Banton was noticing a ‘strong tension’ in her counselling work: ‘even though I find the adverse circumstances are asking a lot of me personally and professionally, at the same time I am witnessing my therapeutic relationships deepening and strengthening. My clients and I may both be wounding, but somehow we are also both healing.’ And in one of our more unusual perspectives, Claudia Nielsen looked beyond the grave for meaning, shining a light on the taboo subject of post-mortem consciousness in ‘I asked Laura what she thought happens after death…’ (see our summer edition for more on our bereavement perspectives)

and making art…

We reached out for artistic contributions from our readers and Twitter followers, and many of them feature throughout our issue. Some of those artists and others wrote for us about how they were finding meaning through creative endeavours. 

Vaithehy Shanmuganathan-Felton, Luke Felton, Celia Briseid and Betty Maitland cultivated wellbeing and mental health through gardening. Lynne Rothwell thought ‘every stitch and row is a small win’ as she recommended knitting and other crafts during lockdown. Health Psychologist Karen Rodham ‘decided that part of my new lockdown routine would be to have a period of reflection at the end of each day. I would choose one event from my day and turn it into a felt image’ (see box, right). Andréa Watts took her ‘coaching through collage’ tool online. Natalia Braun ‘creatively adjusted’ to the pandemic through rhythm and movement. Kevin Dutton, in collaboration with the cartoonist Rob Murray, asked people what they were most looking forward to and then ‘bottled’ that moment. Nicholas Sarantakis drew at the ‘crossroads of the unconscious’, and artist Imogen Mathews was drawn to the ‘ambiguous crossroad’.

Work in a new normal
The pandemic has led to some huge changes in working, with potential knock-on effects for our wellbeing. Sarah Pickup described an ‘evolution of wellbeing risks’ for those who have had to adjust to working from home. Pre-Covid-19, employers were seemingly becoming more concerned about employee wellbeing, although Pickup said that artificial initiatives such as resilience building and raising awareness of mental health do not address primary wellbeing issues. Pickup suggested some broad actions for employers to consider when employees return to work, including a ‘focus on preventative methods through the identification and control of primary wellbeing risks’, and a ‘visible, measurable and accountable strategy… a commitment to a new wellbeing culture’.

Ishbel McWha-Hermann and Rosalind Searle focused on the financial wellbeing side of work. ‘While much of psychologists’ attention has been consumed by dealing with the downstream consequences of inequality, Covid-19 has provided an opportunity to instead focus upstream and to apply our understanding to the source of inequality – wage rates… Investing in people through living wages not only reaps rewards for employees and their organisations; it also addresses poverty at root cause, enabling individuals, families, and societies to flourish.’ As for those out of work, Kelly Camilleri, Katie Voss and Vicki Weare wonder if people who ‘have experienced sudden, uncontrollable changes to their circumstances, and face first-hand the challenges and unpleasant realities of claiming benefits’ now have increased ‘understanding towards those who have been victims of this system for much longer’.

Children and coronavirus
School closures and lockdown in the face of Covid-19 will have affected children of all ages in myriad ways – the lack of face-to-face contact with peers, less chance for play and interrupted education will be felt for some time. 

Counselling psychologists Gail Sinitsky and May Lene Karlsen shared some initial findings from their Children Heard survey. They hope the written and artistic responses to this survey may inspire adults to consider what may be important in building the ‘new normal’. In the face of crisis there is a natural tendency to become more protective of children but, they asked, may this come with costs? ‘When fear becomes an obstacle to hearing children’s voices, are we unintentionally preventing them from being active agents in their lives?’

Janet Empson asked ‘what do children think is normal?’. Empson has worked for 40 years as a developmental and health psychologist and in 2015 published an article on what children thought was normal about their own lives. She has collected children’s views of the coronavirus and lockdown and while, at first, some children saw the lockdown as new and exciting, some younger children have become more emotional and some of the older children are playing new games which involve killing the coronavirus. 

Empson wrote that the mental health implications of coronavirus would be profound, especially for the most vulnerable members of society; she suggested biopsychosocial recovery would take at least 18 to 24 months for many households. Others focused on particularly vulnerable groups of children: having both worked with refugee children on the island of Lesvos in Greece, Health Psychologists Maria Gialama and Sinead McGilloway considered ways we might meet their psychosocial needs during Covid-19. 

Transitions from primary to secondary school and on to university have always been stressful, and Elizabeth Gillies pointed out that during this time of sudden change and uncertainty the skills it takes to cope with transitions should be embedded into the school curriculum. She outlined various key elements which should be taught, and spoken about, to create good transitions. These included having the knowledge that change is part of a typical lifespan, that coping mechanisms we’ve used in previous transitions can help us cope with future change, and understanding the various, strong, emotions which can emerge at times of change. ‘Embedding wider transition education into the curriculum can bring the knowledge and skills of cultural agility. Intentional planning by transition teams in international schools take notice and plan for beginnings and endings.’ 

At the time of writing, uncertainty remained over when and how the majority of children might return to school. Still time to make use of the tips supplied by Naomi Fisher early in lockdown, updating her previous article for The Psychologist with some tips on how to encourage children to learn and thrive while being home schooled.

Towards a new normal
Several perspectives considered lessons for how research is conducted, and changing practice for both psychologists and for people more broadly.

Vulnerable groups were uppermost in contributors’ minds. Natasha Hill, Hannah Jerome and Anna Smith considered the impact of Covid-19 on vulnerable bariatric patients, and how understanding around stigmatised groups may change. Lauren Jenner was hopeful that experiences of the pandemic may help those without autism relate to those on the autism spectrum. Lorraine Crawley shared reflections emerging from her recent clinical work – ‘our clients’ perceptions of the current way in which we are living. While there are of course individual differences in this, there are two emerging themes: “I’ve been practicing living like this for years”, and “Now people will understand what brain injury has been like for me”.’

Susan Brannick’s focus was other animals, as the pandemic brought into sharp relief issues of how we share our planet with them. ‘A simple question about why we treat animals the way we do opens up a vast landscape of psychological theory, including the consequences for categorisation, as well as philosophy, human and animal rights, culture and essentially what it means to be human,’ Brannick wrote. ‘If practices such as wildlife trafficking, deforestation and factory farming are truly implicated in human health outcomes, then this burgeoning body of work offers some much needed coordinates of where we may start our journey.’

In the brave new world of Zoom and Teams, some of our contributors inevitably considered digital and remote service provision. Jeanne Wolstencroft wondered whether the pandemic would be a turning point for mental health care provision, and Nicole Gridley shared how parenting support programmes were adapting to the use of virtual spaces. Lauren Jones and her supervisors reported on a digitally-mediated model for an early intervention multidisciplinary team response to social, emotional and mental health needs in primary school settings in a rural county.

An upbeat ending
Elizabeth Haines, Lauren Taylor, Rachel Ison, Sarah Dunstan, Sarah Hollingsworth, Jessica Blumsom, Holly Ellerton and Danielle Hills wrote a ‘Letter to Psychology’: ‘You were referred following the loss of normality due to the Covid-19 pandemic. Together, we thought about how this has impacted your life. When we first met, you were in a state of shock, and throughout our sessions we explored how you were experiencing a period of grief after this traumatic event.’ They concluded ‘Over the last year we have acknowledged that your progress is ongoing, and your grief may be too, but in the face of this pandemic you have shown resilience and post-traumatic growth. Accepting your “new normal” has allowed you to see yourself from a strengths-based perspective, and you even described a realisation that there are some parts of your “old normal” that you feel should be left behind, for example the limited methods of service delivery. I know that you will continue to show determination to move towards your new normal and you should be proud of what you have achieved so far. Remember you are reflective, hard-working and compassionate.’

Viewing Covid as a ‘catalyst for change’, Richard Pemberton and Tony Wainwright focused on psychology’s political structures and contribution to the public good. ‘The scale of innovation and cross-divisional working within psychology has been truly impressive,’ they said. ‘Will it persist after the pandemic, or will we allow ourselves to retreat back into our all too often fiercely guarded and factional boxes? Will we be able to use the learning from the massive social changes we have experienced to fundamentally reset the way we apply our knowledge and expertise to the other major threat the world is facing?’ Our collective Covid-19 response, Pemberton and Wainwright wrote, ‘demonstrates the value of joined up working and a progressive and effective professional body.’ Turning to topics such as climate change, they concluded that ‘What we do in the coming months will have far reaching consequences for future generations. Paradoxically, this ‘shock doctrine’ [in Naomi Klein’s terms] might be just what we need.’

And that’s where we’ll leave this round-up. As we write, on 9 June, we are still publishing a new perspective on the website most days. The headlines each day are still made by psychology and psychologists. We have stepped up to the plate. Let’s sustain this as we move towards a ‘new normal’.

- For more resources, for the public and professionals, created by the BPS Covid-19 response group, see bps.org.uk/coronavirus-resources

Artwork (top)
‘Here, I was reflecting on how fluid we have to be since everything is changing so often. I was also trying to bring in bits of nature with the strips of colour – nature is an important source of calm at the moment.’ Hayley Gains is a Postgraduate student in Psychology at the University of Exeter, and one of The Psychologist’s ‘Voices In Psychology’ winners.

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