We are living in unusual times, very unusual times. But then at intervals the world has always had to face up to a crisis, be it economic, military or medical, that shook the foundations of the order of the day, many a time resulting in great loss of life and other unsavoury consequences.

Before, during and after such negative developments, the psychological wellbeing and mental health of many is threatened, some more than others. Anxiety starts to exert a tighter grip, especially on those who have low resistance to stress, weak coping mechanisms, and poor, if any, support systems. The Coronavirus cases are no longer far away in China or near in Italy, they are in Malta. After the initial shock and denial, reality is now staring us in the face.

With the aim of controlling the spread of the virus, the authorities have taken a number of measures that changed our life as we knew it just a few weeks ago. Some of these necessary steps, like quarantine, the lockdown of people at risk and the closure of schools, coupled with economic hardship for people receiving less income or simply losing their job, have significantly upped the stress scale.

With this aura of anxiety in the air, many people seem at a loss, and an assorted array of psychiatrists, psychologists, counsellors, therapists and others are willingly plying their experience and expertise to a perplexed population. And so should it be. Yet the answer for many is very near to home: for it is the Self, strengthened through stoicism, resilience in the face of adversity, that can see us maintain our mental health. 

What was done in the past to cope with anxiety on a national basis? Before the second world war, the local medical authorities expected that the island would be attacked on a grand scale, and that as a consequence of the hostilities of modern warfare mental health conditions would escalate greatly. To cope with the projected psychiatric casualties, special wards were prepared at the then Hospital for Mental Diseases, now known as Mount Carmel Hospital.

But medical historian Dr. Paul Cassar says that this increase never materialised. In fact the opposite happened, and admissions actually decreased during the years 1939 and 1944. In times of crises people were too preoccupied with priorities like staying alive and getting on with the business of life to worry about less important, petty and baseless thoughts. This is also borne out from events in bigger countries involved in that war – when psychiatric hospitals were bombed, many detained patients ‘escaped’ into nearby towns and villages and segued silently into society.

From personal experience as a mental health occupational therapist with the armed forces in Jordan during the first Gulf War in the early 1990s, the authorities also expected an upsurge of psychological casualties. With Jordan sandwiched between friend Iraq and foe Israel, the tension was electrifying, especially during the actual six weeks of warfare between Iraq and the US led coalition set up to liberate Kuwait. Yet one way or another people coped, and the expected increase did not happen.   

Years later, working for the WHO in Kuwait on a post-traumatic stress disorder project, I could witness at first hand the atrocities committed by the invading Iraqi troops, as well as the cruel consequences. Again, to their credit, most Kuwaitis had dug deep into their inner resources and turned their suffering into an opportunity for positive growth.

Fast forward to the present, and we have a society more than ever running round to seek a pill for every ill, even when the tools for the solution are at home and all one needs to do is a DIY job. Has a pampered population lost its immune system when it comes to mental health? In a crisis like the present, has suffering stealthily skipped out of our dictionary?

Victor Frankl,  a psychiatrist who lived through the Nazi concentration camps, says that survival depends on having a meaning in life, whatever that may be. It is not the How, but the Why. If one cannot change the situation, one changes the attitude. We have to go back to basics, to purposeful activity, however manual or menial that can be, thus rising above the seemingly hopeless situation and growing out of it.

In his book 12 Rules for Life – An Antidote to Chaos, psychologist Jordan Peterson says that because we are born human, we are guaranteed a good dose of suffering. Alas modern ideology has sold us the concept that human beings are created for happiness, becoming cosseted, comfortable and cut off in the process. But because we are vulnerable and mortal, pain and suffering are an integral part of human existence. In times of chaos and crisis, we have to assume responsibility and try to create order from disorder.

That is why in the prevailing adverse circumstances, whether confined at home or still out and about, we must strengthen the Self by searching for a meaning in life, take up in earnest purposeful activity that we have allowed to rust or that we discarded, contact and communicate with important others – friends, family and neighbours, practice mindfulness by focussing our awareness on what is happening and calmly acknowledging and accepting our feelings and thoughts, and remain positive.

It is a time for change. Not all people are open to it, but in life there is nothing permanent but change. In his Theory of Evolution, Charles Darwin says that when it comes to survival, it is not the strongest of the species, nor the most intelligent, that is successful – it is the one that is most adaptable to change.

We can change in order to cope and adapt to the present crisis. The depth and resources of the mind to help out when one is stuck in a dangerous, life or death situation, are truly amazing. In my student days in Southampton, there was a case of a man who accidentally cut off his arm while chopping wood in the New Forest. Bleeding profusely, he wrapped his arm together in his jacket and ran to the nearest residence, which was about ten minutes away. Arriving, he kicked on the door, and fainted once the residents opened. They called emergency, the man was taken to hospital and operated on. After long rehabilitation, he even managed to regain some function in the sewn limb.

Later, medical experts said that under normal circumstances the man would have bled to death. But wanting to survive, his mind provided that extra impetus to overcome a critical situation, something that is known to happen when one is in a tight corner. Presently we are also in a tight corner. But by strengthening the Self, by being resilient in the face of adversity, we will not be knocked out or end up on the ropes, but eventually we will be holding our hands up high in victory. We can do it. Yes we can. 

 Joseph Busuttil worked as a mental health occupational therapist in Malta and abroad.