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What meanings and values can be found from the past year, and what words will be found going forward?
In mid-March, as we reached the 1-year anniversary of COVID-19’s designation as a world pandemic, there were scores of media articles about what that year meant to our country and world, unsurprising given how unprecedented the year has been in our lifetimes. I meant to do one from the psychiatric perspective, but wanted to obtain the perspectives of both colleagues and the public.
I also thought these perspectives should be brief, given the potential numbers of them, and how that would dovetail with their popularity on social media. Therefore, in a mid-March video, I asked viewers for their preferred word or 2 to describe the year, or more if necessary, and repeated my request to those who I know follow my videos and articles.
Psychologically speaking, we know that when we name something, that in itself provides some comfort in knowing what we are dealing with. Some of that reaction depends on our personal history of responding to stress and trauma, and some to our current circumstances. Therefore, we each differ, and each of us can differ within ourselves over time.
The COVID Year in One Word
In that first mid-March video, posted on St. Patrick’s Day, I provided my 2 single words and why I came up with them. First was BEWARE, which came to mind because March 15th is the Ides of March, the day when Julius Caesar ignored the warning of a seer, culminating in his assassination. Second came EGAD, because of its Oxford dictionary definition that combines anger, affirmation, and surprise, a mix-up of what I had seen over the year.
To both my surprise and not surprise, from adolescents to the elderly, I received many words, well over 50. One-word responses dominated, and they are reflected in Word Cloud #1. They seemed to break down into the following categories.
The Essence of Psychiatry. One of the traditional activities in psychiatry is INTROSPECTION, both for the clinician and patients. That was mentioned 5 times. One goal is ENLIGHTENMENT, and that was mentioned 3 times.
Positive Psychiatry. Many words conveyed positive psychology: COMPASSION, HOPEFUL, RESILIENCE, OPPORTUNITY, KINDNESS, and GRATEFUL twice.
Symptomatic Words. Though not necessarily a reflection of clinical concern, certain words we often encounter in psychiatry were chosen: LOSS or ALONENESS 5 times, along with SADNESS and DEPRESSION. Other negative words were: FATIGUE, STRUGGLING, DISCOURAGED, and UNAPPRECIATED.
Surprise Words. For me, hearing 2 clergy use x-rated words was a surprise, even if they seemed to be conveyed with a bit of tongue-in-cheek. The word SURREAL was unexpected, and I had to look up what INTERREGNUM meant.
Opposites. Perhaps reflective of mixed feelings were pairs of words that were opposites: YIN and YANG; FRIGHTENING and ENLIGHTENING; PARALYZING and CATALYZING; FEAR and NO FEAR: LOSS and GAIN; and CERTAINLY UNCERTAIN.
After reviewing that list, I thought of several words that I anticipated being there, but were not. ZOOM was one, given how common it is now. Perhaps it escaped mention precisely because it has become so routine. LOVE is another. Certainly, passionate love is more of a 4-letter word in psychiatry, given the ethical principle against that between a clinician and patient. But what about the increase of being home more with loved ones? Then there is the love of care and compassion, the kind of love I recommended for administrators when I received the Administrative Psychiatrist Award from the American Psychiatric Association in 2016. HELP was yet another, perhaps because it is not clear when and what kind of help is needed for normal reactions to an abnormal situation.
The First Week After the First Year
Given the promise of the vaccines, someone like myself might assume that more individuals would be optimistic about year 2 of COVID-19. Yet, the first week indicated how unrealistic that may be. Our country was hit with at least 4 major crises. One is the horror on our border with Mexico, the children who are alone with an uncertain future. The second one was predicted by many, but allowed to occur anyways, which was the spring break crowds in Florida, with some added mayhem. Then, after the COVID-19 year of markedly reduced mass murders, we had 2 in a single week: one near Atlanta where 8 were killed, 6 of them being Asian women; the other in Boulder, where 10, including a police officer racing to the scene to help, were killed in a grocery store where our basic need for food is fulfilled.
These traumas and tragedies necessitated adding them to the video I did on March 24th, when I was planning to discuss the responses of our audiences. On that same day, I contacted the same audiences to see what their words were a week later, as displayed in Word Cloud #2. Some kept the same words. Many went to more negative words. Introspection was no longer submitted.
I picked WHIPLASH this time around, feeling once again, despite my prophetic aspirations, that my mind was shocked by yet more unexpected tragedies. A new 4-letter word that I was expecting that was not submitted was GUNS. There were 2 new submissions of non-English words: the Hebrew one of MITRAYIM, related to the upcoming Passover holiday and the need to emerge from narrow and constricting physical and psychological spaces; and the Hindu one of SRISHTI-STHITI-PRALAYA, which refers to the ongoing cycles of Creation-Maintenance-Destruction, of which we might be in the destruction phase now. If anything, the words for a week later seemed to refer to our grey state of uncertainty about where we are headed, for better or for worse.
Two or More Words
For both time periods, 2 or more words were submitted, but they are not shown on our Word Clouds. They include: GO WITHIN; A REMARKABLE PASSAGING HOPEFULLY; ANNO COVIDI; BIOPSYCHOSOCIALCULTURAL GROUNDING; DEEPENING SOCIAL SENSITIVITY; SAD AND LONELY; SAD AMERICAN or SAD TO BE AN AMERICAN!; SHOULDN’T HAVE HAPPENED; AN ANXIOUS EXISTENCE; OY VEH; HUMBLING AND HORRIFYING; PRESENT MOMENT; and UNLEASHING OF WRATH ON HUMAN SURVIVAL.
Both times, some contributors added explanations for their choices, all of which provided extra value. In fact, VALUE was one of them. Here are some of them in their anonymous authors’ own words.
VALUE: “The first word that came to mind was value—in all its iterations. I think this extended moment in time/history has demanded that we rethink what we value, how we measure value, what we consider valuable, how we manifest value(s). . . And, of course, it’s a derivative or sibling to valor—that of heroes.”
STRUGGLING SUPERMOM: “Maintaining many jobs: psychiatrist, improvised special education teacher, speech, occupational and physical therapists, and solo crisis team, and extremely sleep deprived!”
AVOIDABLE: “Without sounding like a conspiracy theorist, I have deep suspicions about China’s role in it, above and beyond what ‘accidentally’ happened in their lab.”
ANNO COVIDI: “As I’ve been calling it in my writings, has been something akin to a repeated stress test—increase the speed, the inclination and let’s see what your heart can take and what you’re made of.”
LOSS AND GAIN: “I lost my mother and gained a daughter-in-law. What a crazy dichotomy.”
ROLLERCOASTER: “Coping with change and loss, getting under control, then it all falls apart and you have to do it and get on top of it all over again. But you are resilient, so you do it and move on. And there were some good things which happened during this year from hell. Being grateful, more exercise, closer to nature, connecting with folks, etc.”
RETURNING TO BASIC LIVING: “Or, rediscovering that we need family almost more than anything else.”
UNBELIEVABLE: “Unbelievable that it was such a disaster and unbelievable for the ability for people helping people.”
DISCOURAGEMENT: “Regarding those who ignore the need to consider their fellow citizens, by ignoring science and reality.”
ISOLATED AND UNAPPRECIATED: “It was the longest hurricane that I didn’t have to sit through with my elderly grandparents. This year was like a 90s mash up of twister, Dante’s peak, and brave new world with modern English singing ‘I’ll melt with you’ on half speed in repeat in the background with Jim Carrey dancing across my lawn in a tutu leading a parade of small children dressed as the Arctic creatures our lack of climate policy is slaughtering.”
DESTABILIZING AND REORIENTING: “Once a community has a massacre, there is life before and after that event. Same for the pandemic except that one horror is acute and the other is chronic. Either way, there is surely some degree of PTSD to set in. The King Soopers on Table Mesa is the hub of our South Boulder community, and now it is a crime scene and will forever be a reminder of the darkest shadows of our American reality.”
BUOYANT: “The world has endured stormy waters. No matter how far we are submerged, humanity always resurfaces. The pandemic has pushed us in very deep, but this just means we will re-emerge more rapidly, according to Archimedes’ principle!”
These words, phrases, and explanations of our readers have both personal and general implications. It seems all of us started with some degree of built-in evolutionary reaction to perceived danger, “fight or flight,” when COVID-19 was deemed a pandemic over a year ago. It was a unique danger for our time—not only was it invisible, but it posed a danger of dying. Flight can not only fit the social distance recommendations, but internal flight to deny the risk. Fight can include all those on the health and essential frontline services. Then, we add on our individual variations that can complement any general review of our COVID-19 year. Although the surveys were on both mental health professionals and the public, there didn’t seem to be major differences in the responses of the 2 populations.
However unexpectedly, the first week afterwards added some concerns.
1. The relay hand-off of group scapegoating. Over the year and continuing in this week, scapegoating has gone from Asians to Black Americans to Jews to Navajo Native Americans to Hispanics to sexism, and most recently likely to Islamophobia given the Muslim identity of one perpetrator. All scapegoated groups may need to try to support each other to avoid being divided and conquered by those in power.
2. Gun violence has waned and waxed. Though mass killings by guns were down in the COVID-19 year, mass shootings were not. Why, though, did we have 2 mass killings in this first week after the COVID-19 year? Was this a form of societal regression? A backlash to the new government, similar to Lincoln’s assassination and the dismantling of Reconstruction after the Civil War?
3. The mental pandemic is bound to continue. Given the amount of prolonged grief and the typical delay of PTSD symptoms, we are bound to see more as time goes on. Usually, we cannot see all of the effects of crises until they are over. In particular, frontline health workers are at high risk, which may require ongoing outreach with screening and services.
The best projection, perhaps, is that even with the invisibility of the virus and its ability to mutate, individuals have the potential to do what is necessary to come out of this portal with gains of gratitude and global cooperation. Will we?
喜怒哀乐 Xǐ nù āi lè
喜 is to love, 怒 is anger, 哀 is sorrow and pain, and 乐 is happiness. All together it means that we feel all the emotions all at once.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of being a Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He has recently been leading Tikkun Olam advocacy movements on climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board ofPsychiatric TimesTM.