Can Anything Cure the Pandemic of Waiting and Worrying?

A Psychologist of Uncertainty Has Some Ideas to Help Us Cope With This Unprecedented Time

Can Anything Cure the Pandemic of Waiting and Worrying? | Zocalo Public Square • Arizona State University • Smithsonian

COVID-19 has created a second pandemic of worry and waiting, writes psychology professor Kate Sweeney. Courtesy of Wikimedia Commons.

The sources of uncertainty are numerous right now. Will my job still be there when the pandemic ends? When can I see my friends and family again? Is it safe to go to my favorite restaurant or get a haircut? Will I get to take that trip I planned for next year? Will I get sick? Will someone I love get sick? Will one of us die? The uncertainty itself is crippling—triggering distraction, anxiety, and even physical illness at exactly the time we all need to be calm and strong.

But there’s good news. While the COVID-19 pandemic may be unprecedented by many measures, the same combination of uncertainty and loss of control it’s triggering is a close psychological cousin to the waiting periods I’ve been studying my entire career. And the insights I’ve gleaned from nearly two decades of research can illuminate the nature of our current psychological predicament and point toward a happier kind of coping.

In my field of psychological research, I study stressful uncertainty, particularly the kind of uncertainty that arises as we wait for an unknown, but anticipated, outcome. I’ve turned the experience of waiting inside out, seeking to understand every facet of this common and distressing psychological state. I’ve studied soon-to-be lawyers waiting to learn if they passed the bar exam, students waiting to learn their grade on a class assignment, researchers waiting to learn if their paper will be published or their grant funded, patients waiting to learn if they have cancer, and voters waiting to learn if their preferred candidate will be elected to office.

The waiting periods I study vary in a number of ways. Some are life-changing, like waiting for a biopsy result. Others are minor bumps in life’s long road, like waiting for a grade on a book report. Some entail waiting many months for important news, others require a wait of just hours or days. In some cases, the waiting period has a definitive end; exam scores are posted online, or a doctor’s appointment reveals a diagnosis. In the case of COVID-19, the wait is open-ended, with no clear end in sight.

Despite these differences, my research has uncovered two features that nearly all waiting periods have in common: uncertainty (we don’t know what’s coming), and loss of control (we can’t do much about it). Both play a central role in why the act of waiting is so challenging. While either of these states is existentially uncomfortable even on its own (after all, survival requires an ability to anticipate future threats and opportunities, as well as an ability to direct one’s fate), together, they make for a fearsome duo—so fearsome, in fact, that many people prefer to get bad news than to remain in limbo.

The stress brought on by COVID can be characterized by that same combination of uncertainty and loss of control. Back in February, my fellow collaborators and I surveyed more than 6,000 people in multiple cities in China, when the virus was at its peak there. Hoping to get a snapshot of how people were feeling and coping during this unprecedented period, we asked participants lots of questions about their physical and psychological well-being—how they were coping, their personality, and their circumstances (for example, whether they were in quarantine). As expected, people who were most uncertain about their risk of contracting the virus and felt that they had little control over their risk were the worst off in terms of well-being. They were more anxious, depressed, and lonely than their counterparts who felt more certain or more in control. They also reported more unhealthy behaviors, like binge drinking and eating junk food.

If you feel like it’s been an eternity since you first heard the term “COVID-19,” there’s a good reason for that, particularly if you find yourself worrying a lot about the future.

Waiting is so difficult in part because time seems to slow down when someone is worried about the future, which has the effect of prolonging their uncertainty (at least in their mind). Surely everyone has experienced how time can expand and contract, such that an hour feels like mere minutes during pleasant activities, and a minute can feel like an hour during unpleasant ones. Although this process isn’t fully understood, it seems that we’re prone to missing the “ticks” of our internal clock when we’re pleasantly distracted. In contrast, stress makes the clock seem to accelerate, which accumulates more “ticks” and thus extends the apparent passage of time.

Several studies from my lab show that this “slow time” may actually exacerbate anxiety and other forms of emotional distress. We surveyed, for instance, law school graduates awaiting their bar exam result and college students awaiting an exam grade. In both studies, we repeatedly asked participants whether it felt like it was “taking forever” to get their exam result or if they felt like they would learn the result “before [they knew] it.” We also asked how they were feeling, both physically and emotionally. When we linked up these various measures, it was clear that people who felt worse also felt like time was moving more slowly, and people who felt like time was moving more slowly felt worse.

This reciprocal relationship can create a downward spiral. Worrying makes the days feel longer; the tedium of seemingly endless days ramps up anxiety. In short, if you feel like it’s been an eternity since you first heard the term “COVID-19,” there’s a good reason for that, particularly if you find yourself worrying a lot about the future.

Waiting periods don’t just affect your emotional health; they can affect your physical health as well. In research I conducted with psychologist Jennifer Howell, we found that people felt sicker and slept worse during the most worrisome moments of a waiting period. In the same group of law school graduates who helped us understand the dynamics of time perception during waiting periods, we also asked about their “subjective” health (how sick or healthy they felt) and how well they were sleeping. When we linked up these variables, we found that people reported feeling sickest and sleeping the worst during weeks in which they were particularly worried about their exam results.

Several other studies, including our recent survey in China during COVID-19, provide a clue as to why health suffers during these periods: People do not cope well with the emotional and physical strain of uncertainty. There’s a good reason a common theme among COVID-19 memes has been a reference to gaining the “quaran-fifteen”: people are eating worse and consuming more alcohol than they would during regular periods of stress.

Humans are equipped with a rich array of well-learned coping strategies that are quite effective in some stressful situations. These strategies, sometimes shorthanded as the “psychological immune system,” highlight that humans are quite capable of combatting and even neutralizing threats to their emotional health. We rationalize the bad things that come our way, telling ourselves “it’s not me, it’s them” when someone hurts our feelings, or “they don’t know what they’re talking about” when we get a bad performance review. But without a clear sense of what threats lie ahead, the psychological immune system has no clear target to attack. You can’t fight an illness that you don’t yet have, metaphorically speaking.

While the challenge of coping well with uncertainty is formidable, research from my lab has already identified an entire toolkit of strategies that may be effective during such periods, including mindfulness meditation, experiences of awe, and positive fantasies about the future. Notably, our COVID-19 survey in China suggests one particularly promising pathway to well-being during the quarantine-like conditions that are the norm in many parts of the world right now: flow.

Flow, it seems, might hold the key to making various forms of self-isolation more tolerable, offering us enough of a pleasant distraction to miss those “ticks” of our internal clock. People most commonly experience this state of complete absorption during activities that are appropriately challenging (not too hard, not too easy) and provide opportunities to track their progress. Video games, for instance, are custom-made to create flow, but people also experience flow while gardening, cooking, playing sports, even working; the best flow activities differ for each person.

In our study, we asked people whether they had been experiencing flow during the previous week. Those who reported experiencing a lot of it also reported feeling better on nearly every measure of well-being: less anxious, less depressed, less lonely, and so forth. More importantly, those in quarantine (about 30 percent of our participants) reported feeling almost as good as those not in quarantine when they experienced a lot of flow.

We may be stuck with COVID-19’s pandemic of uncertainty for months or even years to come. But at least by understanding what the virus has unleashed on our pandemic-era brains, science can point the way toward how to make this waiting period feel more manageable. Because equipping ourselves with effective coping strategies is crucial for surviving—and perhaps even thriving—during this time.

Kate Sweeny is a psychology professor at UC Riverside. Her work on uncertainty and related topics has been covered by the New York Times, the Washington Post, and NPR.
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