Psychosocial control of COVID-19

“A lot of the challenges that we’re facing right now are behavioural challenges,” says Jon Jachimowicz, a professor of organisational behaviour at Harvard Business School. The extent of the coronavirus’s spread will also depend on the actions or behaviour of individuals, many of whom may lack any symptoms of infection — a crucial factor that will determine the effectiveness of the new rules and regulations over several weeks or even months. COVID-19 has taken a heavy toll of human lives. It’s time to think about how to manage our lives in a world of contagion.

As British epidemiologist Adam Kucharski explains in The Rules of Contagion, there are four factors that feed into the R: the duration for which a person is infectious; the number of spreading opportunities per day during that infectious period; the probability that an opportunity leads to transmission; and the susceptibility of the population.

We also need more understanding of individual behaviour and group behaviour in a pandemic scenario. It’s not just about mitigating the risk but also managing the perceived risk. Human behaviour will determine how quickly COVID-19 spreads and mortality. Behavioural science has a crucial role to play in the response to this deadly virus. It is the observation of regularities in how people behave.

A review of advice from the World Health Organisation, Centres for Disease Control and Public Health, England suggests 13 behaviours important to reducing transmission. The relative importance of each behaviour may differ from country to country, depending on the local context. We must now consider how to meet these challenges.

Behavioural health practice is a multidisciplinary field that promotes optimal mental and physical health by maximising biopsychosocial functioning. Evidence-based behavioural practice entails making decisions about how to promote healthy behaviours by integrating the best available evidence with practitioner expertise and other resources. Psychologists, economists and neuroscientists around the world have been working at breakneck speed to identify evidence-based solutions to those behavioural challenges, using behavioural science to help fight the coronavirus.

The good news is that there is evidence from a previous research that many individuals will act in ways that go against their best interest for the greater good. The paper also highlights three factors that would make such altruistic behaviour more likely: clear communication, feeling a sense of community and some form of punishment—social disapproval, for example—for those who break the rules.

In the last few weeks, people have reacted differently to the disruptions from COVID-19. There has been an overwhelming feeling of unfairness and uncertainty about how life will be tomorrow, next week or a month. Anxiety levels have been high. However, in a world of uncertainty, the teaching and practices of the Hindu Dharma are helpful in taking care of ourselves.

Accept your feelings - anger, frustration, fear, loneliness - which we are experiencing to encounter the discomfort COVID-19 is causing. We cannot move on or overcome it, and suppression will only bring psychological problems. You’ll find that when you accept your feelings, rather than fighting against them, we can tap into our inherent goodness more easily. We can see things more clearly, be more positive, and appreciate the opportunities that have become available to us — to spend more time with ourselves or with our loved ones at home.

When you can or can’t control it, our dharma today is to first and foremost follow the guidelines being put out by our government to protect ourselves, our families and our communities. Remember all the while some of the many principles of dharma: Satya (truth), ahimsa (non-harming), karuna (compassion) and aparigraha (non-greed) while making decisions but let go of the expectations of the results. This can bring the much-needed clarity and peace.

Lev Vygotsky cognitive theory believed that parents, relatives, peers and society all have an important role in forming higher levels of functioning. We found psychologists love to encourage people to use all their senses in grounding techniques, and Hinduism offers many ways to engage in them. People follow those from their upbringing (childhood).

At this point, it is necessary to understand the Nepali behavioural pattern, which is almost forgotten, or a new learning is taking place through the process of globalisation. Behaviour is a product of learning - when it is learned then we can unlearn, relearn and modify it according to the demands of the situation. Many learning theories are postulated, simply said. Operant conditioning describes how we repeat behaviours because they pay off for us. It is based on a principle authored by a psychologist named Thorndike (1874–1949) and is called the law of effect. The law of effect suggests that we will repeat an action if it is followed by a good effect. On the other hand, Albert Bandura is a leading contributor to the social learning theory, in which many of our actions are not learned through conditioning; rather, they are learned by watching others or modeling.

Behaviourists used three principal learnings – New Learning, Unlearning and Relearning. It is time for the Nepalis to relearn our cultural pattern of behaviour, for example: maintain distance when you are together with others; wash your hands always when you touch something; keep the kitchen pure and clean, not allowing others to enter it; keep your shoes outside the home; greet with a Namaste by joining the palms of your hands together; and eat hot and fresh food while maintaining the concept of jutho (when any food is considered impure when you touch it with the hand you are eating).

Vygotsky's theory argues that cognitive abilities are socially guided and constructed. As such, culture serves as a mediator for the formation and development of specific abilities, such as learning. Learning is greatly influenced by how a culture socialises with its children and young people.

People should relearn that unlearned behaviour to combat COVID-19 - maintaining social distancing, which benefits our fellow citizens. My behaviour affects your chance of contracting the disease and your behaviour affects mine. Such collective action problems have been studied by behavioural psychologists for several decades.

Further, we have the ability and responsibility to take care of ourselves holistically-physically, mentally and spiritually. Nourish yourself with exercise and food you enjoy, and use your time to do creative and productive work that help you move towards your values, towards your dharma. Karma is one of the traditional goals of human life as per our Hindu teachings, and it is important to find both meaning and joy in these times.

Social distancing does not mean social disconnect. People find many ways to connect with friends, family and others through the Internet and get help and spend quality time with them.

Puja  is a devotional call upon all the senses: the smell (olfactory) of dhup (incense), the reverberation of a bell (auditory), visually pleasing murtis (idol), the sensation of bringing our palms together (cutaneous) and the taste (gustatory) of prasad melting in our mouths together in a puja can be lovely ways to overcome stress.

Psychologists have proven what we know intuitively: music (singing) can decrease stress, and bhajans (devotional song) with their uplifting lyrics can bring peace of mind. Expressions of art and dancing make you busy and inspire you to live a lively life.

Beware of your distress and think when you need help from others or experts. If you’re feeling aches and pains not requiring medical treatment, they may be due to the suppression of stress or depression. If you feel like you can’t control recurring thoughts and are experiencing physical symptoms of anxiety - sweating of the palms, shallow breathing and palpitation - you don’t have to keep suffering. There are psychologists, psychotherapists and counselors who will listen to your problems and give good counsel. Tele-psychology/tele-mental health services are provided by many associations and institutes.

These unprecedented times have brought unprecedented levels of distress upon us all, and taking care of ourselves is important. It’s important to be kind and patient with yourself, as you navigate though the circumstances and figure out your dharma (duty) and do Karma (perform) at this moment. Humans can endure any circumstances if they have the will. Hence, follow the idiom “Live and Let Live”.

Subba is with the Association of Psychologists in Nepal (APN)