In the time since Covid-19 has taken the world by storm and information has, itself like a virus, spread across the globe, vast sections of the population have been tormented by health-related anxieties. New ones have quickly appeared – of inadequate supplies of antiseptics or food. Now, while this type of threat to world health pushes the limits of our understanding, we have seen it before with H1N1, Sars and others. As cases of Covid-19 and casualties increase, dread, panic and anxiety among the population also spikes. The more informed one is about this virus – one article leading to another, one video leading to another – the more the thirst to know more. This inability to stop gathering information exemplifies a form of pleasure. Indeed, there is a certain enjoyment in being frightened, worried or anxious. Jacques Lacan, the French psychoanalyst, had a term for it: jouissance. Human beings find some pleasure in tension, just at the point where pain begins to appear. This indulgence in pain is the underlying motive of the repetition compulsion at work: people feel compelled to repeat unhealthy behaviours, like tirelessly accessing information about Covid-19, ranging from reliable to dubious. The repetition compulsion also explains why individuals might remain in an emotional state, ranging from an anxiety that is specific to contracting this virus to a generalised one, touching upon all areas of a person’s life. Let us take a look at what anxiety really is: a feeling of displeasure that translates into physiological sensations (shortness of breath, racing heart, sweatiness, trembling, heavy chest, etc) that is accompanied by intense psychological suffering. Even though it makes us feel uncomfortable, it has an important adaptive function. Anxiety is a survival instinct living creatures are equipped with. Whenever it is felt, it signals an impending threat that cannot be named. Most of the time individuals cannot make sense of it. Anxiety puts us on defence mode and propels us to find ways to cope with stressors. Anxiety can be either an involuntary or unconscious reaction to a situation that is potentially dangerous or it can be a voluntary and conscious reaction to a threat, allowing him or her to avoid that danger. Covid-19 is a threat that triggers both those types of anxiety, representing both an actual and a potential threat. If anything, anxiety is a healthy reaction to threats. It becomes problematic when it is excessive, because then it stops serving its protective purpose and renders people unable to cope. Like other “negative” emotions, anger and sadness, it’s important to experience anxiety in doses. A moderate amount of anxiety around contracting Covid-19 leads us to improve hand hygiene. At the same time, large amounts of anxiety can prompt us to engage in excessive hand washing, buying large quantities of disinfectant and overestimating our risk of contracting the disease. Such behaviour in turn amplifies anxiety and makes this behaviour cyclical. Fundamentally, when it comes to stress, desirable amounts motivate and help us achieve goals whereas undesirable amounts compromise our functioning and can cause us to withdraw. Anxiety is a signal of imminent threat, but it also constitutes a screen that can insulate us from the deeply rooted, unconscious fears it actually represents. I use psychoanalysis in my practice to help individuals gain insight of those unconscious dynamics. The psychoanalytic perspective can be utilised here to shed light on this particular threat to public health that the scientific community still does not fully understand. Covid-19-related anxiety has two psychological specificities that can explain the intensity with which individuals experience it. The first is that it triggers our primal fears. These are primitive anxieties we are born with – the trauma of birth (that is, the trauma of being born) being the paradigm of all anxieties. Primitive or originary anxieties refer to the state of absolute dependency of the newborn and include the anxiety of falling apart into bits and pieces (fragmentation), anxiety of disintegration and ultimately, the universal fear of return to the womb, annihilation and death. These anxieties are normal at the beginning of life and subside as a baby forms secure attachments with its caregivers. By being held, looked after and cuddled, the baby acquires a sense of wholeness and security. It is precisely our sense of inner safety, integrity and wholeness that Covid-19 presents a threat to, exacerbating our fear of death. The second specificity of this virus is that it creates a divide among individuals. It forms an “us, healthy” versus “them, infected”, and transforms the other human being – say, the person sitting next to me – into a threat. It thus turns us against each other. It is also the basis of xenophobia, individuals form an “us” that is superior to “them”. But we cannot fight fear of Covid-19 by giving in to fear. We fight fear with solidarity and mutual respect, by looking out for each other, keeping each other purposefully informed and supporting each other. This is not a disease of only a particular group of people. It concerns us all. In addition to the benefits of gaining insight into anxiety related to the deeper meaning of Covid-19, there are ways through which we can keep our fears under control. For one, prevention needs to be at the centre of our attention. Hand washing, abiding by hygiene etiquette: not coughing in anyone’s direction, into the elbow, not palm, not touching our face, keeping a distance of at least one metre from anyone who displays flu symptoms and keeping our immune system strong. We have to limit our exposure to information by allocating time per day to get updated, and by turning only to reliable sources. Sources need to be backed by scientific data and government entities or international health organisations. Catastrophising must stop. We need to keep things in perspective and refrain from jumping to the worst conclusions. Communication channels with our children must be open. Ask them what they know about this virus, inform them with age-appropriate language but most importantly, model personal hygiene. Children learn by practice and imitation of consistent adults. They pick up on emotional cues in order to regulate their own emotions so use a calm tone. Calmness cannot be overstated. As it is, anxiety comes in waves. When it begins to mount, practice deep abdominal breathing, bring ourselves to the present moment and space, and use positive self-affirmations – reassuring ourselves that things will be okay often does the trick. If none of this helps and if anxiety begins interfering with daily functioning – such as our ability to work and maintain personal relationships – seek professional help. It is important to understand that health anxiety is only the tip of an iceberg. Below the surface of the sea, lie its deep roots with unconscious dynamics that can relate to our personal story. <em>Dr Vassiliki Simoglou is a counselling psychologist at Thrive Wellbeing Centre by Dr Sarah Rasmi </em>
