Grief vs adjustment, the most benevolent diagnostic code therapists can use for insurance paperwork is Adjustment Disorder. Also known as “situational depression,” an “adjustment disorder” suggests an individual is going through a challenging transition, anything from a recent move to the birth of a child to a difficult breakup. The term describes most people at any given time; life, after all, is nothing if not a series of changes.
It’s also the diagnostic code I’ve been using to describe the discomfort and disorientation my clients are facing during the COVID-19 crisis. As a psychotherapist in the San Francisco Bay Area, I switched to teletherapy the week Mayor Newsom issued a state-wide, stay-at-home order. And since then, I’ve had an up-close-and-personal view of the myriad ways the pandemic has affected the population.
Today, my client *Renee confessed feeling conflicted about moving out of shock and into acceptance of the “new normal.” As she put it, it feels “wrong” to skip over global changes and widespread tragedy and simply adjust.
It’s not that Renee hasn’t suffered. She felt disorganized and drenched in anxiety and “displaced” during her first week of quarantine, as she’d long kept strict boundaries between work and home. Growing up, her learning disabilities rendered school a place of struggle and home her refuge, and she’d worked towards creating the same in her adult life. Now, restricted to her home—and not by choice—the familiar strain to manage work crises feels both inescapable and untenable, despite the more pressing issues at stake in the world at large.
While the opposite held true for me as a child—school was my haven, as verbal and physical abuse were the only guarantees in my home—both she and I are in the single-woman-home-alone-with-pets quarantine pod. There are plenty of us. Some crave physical contact more than ice cream; as one Tweeter remarked, “I now understand why sequestered Disney princesses were moved to song by the distant prospect of sexual contact.”
Others, namely introverts, are luxuriating in their isolation as if it’s a hot tub. One of my clients, who likes a lot of space, was asked by her fairly new boyfriend if she’d like to shelter-in-place together, to which she said, “That is my worst nightmare.” Another client asked me, with a subtle mix of curiosity and horror, “What’s it like being…alone?” as if she was asking to feel my horns. (It called to mind the way Christian children looked at me at the church I attended as a friend’s guest. What’s it like being a…Jew?)
Talk of silver linings scamper across the internet in between memes of dads adopting childcare duties (how foreign) and devastating news stories. And I’ll agree there are several bright sides to quarantine. Solitude, for me, can be a sheer joy. I write, meditate, cook, take long baths, watch movies in the middle of a Tuesday. But there’s a darker underlining for us singles, too: The fear that if we’re in danger or die, no one would know, unless, of course, we have someone we speak with daily. And if not? Our singleness isn’t so Carrie Bradshaw-cute anymore. Our aloneness is not only illuminated but also amplified.
Whether single or coupled, the COVID-19 crisis has forced many of us into moments of stillness and quiet that feel alien and uncomfortable. The internal sensations and emotions we’ve long kept at bay through busyness and the comfort of others has urged a range of issues to the surface. It may manifest as hypervigilance or anxiety or depression or paralysis. Renee felt so overwhelmed that the thought of starting something new, even a new book, felt fraught—what if something bad happened in the novel? While others are catching up on the movies they missed and some are learning new hobbies, she needed the familiar to soothe her nerves. No matter its shape, these feelings of overwhelm would be classified as dysregulation.
For many trauma survivors—a big part of the population I serve—it takes much less than a pandemic to provoke dysregulation. Navigating terror, for them, is often life as usual. One client, who was raised by a hyper-critical mother, has internalized her mother’s voice—a relentless interior presence that dictates what she gets to eat, when she gets to take breaks, and if she deserves pleasure. These days, she feels a certain degree of comfort in the level of anxiety her friends are now experiencing.
Grief vs Adjustment: The Real Story
Each pod seems to have its own sub-pod. There are Parents-Home-With-Kids, and within this are those who use IG for boast posts to document their homeschooling successes. There are also those drinking chardonnay and letting their littles have more screen time than they’d typically allow all year. Parents who are coming together as teaching tag-teams; parents doing it alone as if they’re single, their partners checked out in the background. Parents circling their own childhood trauma drains; others who are relishing this newfound time with their kids.
Couples are experiencing just as much tense emotions as we singles, if not more (or at least a different shade). How to stay safe and respond wisely can be surprisingly polarizing for couples that usually get along without a hitch, just as it can ignite fire in relationships that were emotionally-charged pre-pandemic. At the end of the day, when I’m home alone with my dog, Toshi, I often find myself thinking about a couple I’m working with.
They were planning on moving at the end of March. He’s emotionally volatile and doesn’t know that the move was supposed to indicate the end of their partnership. Now they’re quarantined together. Will there be a quarantine baby boom come November? Speculations abound. In the meantime, the divorce rate in China is rising as couples emerge from SIP.
While we’re discouraged from leaving our homes—the freeways and city streets around us barren—the pace of life in the U.S. has yet to slow down. There seems to be a pervasive urgency to maintain the status quo, even if it is slightly altered. People are filling their time with virtual happy hours and book clubs conducted on FaceTime. Families are competing in the Petelon challenge. Yoga and barre classes and CrossFit are blowing up Zoom. Some are taking on the 30-day burpee contest; others are hitting the quarantine 15 through panic snacks, baking, and drinking.
Many are exploring side hustles; others are bemoaning how little they’re getting done. I do nothing all day, a friend said, and then at night I start freaking out because I still have so much to do. But really, how can we expect the same degree of productivity from ourselves than we did four weeks ago?
On the other hand, the impulse to slow down is just as extensive. I assure my clients and myself, as I fall into this category too, that this unhurried pace isn’t laziness, or the fatigue that generally follows anxiety and an adrenaline rush, especially one of this magnitude. This inclination to slow down, even if it doesn’t feel voluntary, is our sorrow speaking out. It feels like grief—the drag of walking through water fully clothed, pants and jacket soggy and heavy—because it is grief.
And how can it not strike? When my godmother died, I stayed in bed, unable to move. I watched the sun rise and set behind the blinds and thought, How does that still even happen? With my brain saturated with sadness and my limbs burdened by the weight of grief, I forgot how to cross a street, terrified I couldn’t move fast enough before the light turned red.
If one death does this, how does losing our livelihood and imagining the overall mounting death toll affect our ability to function? As Americans, we have high standards when it comes to efficiency. And when we’ve based all of our self-worth on productivity and material successes, who do we become once we slow down; when our external trappings are, well, kinda pointless? Once we loosen the reins on who we’ve been? This is the crushing but exciting question I’m sitting with.
I’m not the first person to suggest this and I certainly won’t be the last but it seems that in slowing down, we can grieve before we adjust to this new normal. This grieving doesn’t just seem natural—it’s necessary. Now is the time to see beyond our four walls; to recognize that our communal sadness is valid and unavoidable. And that there is a purpose behind it.
We can use this collective trauma to deepen our compassion, empathy, and care for one another. The real silver lining of this experience is that it’s lifting the veils we’ve lived behind for years, decades, even lifetimes. We’re seeing people and situations and circumstances to which we were previously impervious.
We cannot un-see what we have seen, from those who have been refused help because of a lack of health care to bodies in the streets of Ecuador, and we can do something with it. It makes me think of a friend who, upon seeing the destruction of the Great Barrier Reef, stopped working for Monsanto and became engaged as a climate change activist. It also makes me think of another client, an ER nurse whose podiatrist said he couldn’t understand how she could walk when her feet were so flat and in such bad shape.
After starting somatic work, which returned her to her body and cultivated presence, she felt the enormity of her pain. Mastering disassociation protected her from the gruesome realities she had to navigate at work and helped her perform her duties, but at what cost? If we can’t feel ourselves, how can we feel other people?
To feel ourselves and others, we must, in the words of Ram Dass, “be here now,” not busying ourselves in preparation for an undefined future before taking our emotional temperature. While Renee and I discussed our mutual hope that the pandemic will redefine the pace and priorities of life—that within this tragedy rests possible rewards and great promise—our hearts are also breaking for the escalating losses: loss of autonomy, routine, and normalcy.
The loss of thousands of human lives and the untapped wisdom of the elderly who are among them. The loss of innocence around our perceived invincibility, and the inability to have ritualized closures to the deaths we’ve had to deal with. Personal safety. Financial security. The loss, despite being rattled by 9/11 and regular gun violence, of general safety.
The loss of any certainty, no matter how productive we may be, that we can dictate how our lives will unfold. And the pod within this all: Ambiguous loss and its bedfellow, anticipatory grief—that anxiety-ridden, “lingering sense,” as Healthline put it, “that more loss is still to come.” We realize life will never be the same, but what, precisely, have we lost, and what more will we lose? In many ways, it’s akin to mourning the dissolution of a relationship, when we grieve not only what was but also what could have been.
As I’m grieving, I’m also grieving for the most vulnerable people in our society, where “shelter-in-place” is hardly synonymous with “safe:” Homes empty of food and medical supplies; homes marked by child abuse and domestic violence. Children who count on school lunches to get enough to eat. People who are easily triggered. And, of course, those who have no homes at all.
In the same breath, I also realize that those who know dangerous homes and violent relationships—as well as those who have been in gangs or prison or have otherwise suffered from PTSD—may actually be more prepared for this pandemic. They/we know our way around the exquisite hold of waiting to exhale. We know unpredictability. We may even be energized or find comfort in the familiarity of this heightened state of alertness. Of being primed for action. It’s when we slow down that a different tint of grief assaults us: The grief of being alone, the grief of powerlessness, the grief that awaits.
But what I hold to is this: If we can be united in sadness and discomfort, we can also be united in empathy. Traumatized or not, in a peaceful home or without, many are working towards cultivating a community of compassion. They’re giving blood, making and distributing free hand sanitizer, chalking “Stay Safe” messages on sidewalks, leaving out baskets of free lemons with signs that say We are in this together. They’re refusing to take on the collective fear, just as they’re refusing to skip over grief in the name of self-improvement or career advancement.
If we adjust too fast, we miss these small kindnesses, just as we miss recognizing and savoring the positive changes around and within us: More time outdoors. Safer bike rides on empty streets. The elastic time, which can fuel creativity. The emotional intimacy that may exist during what I’ve dubbed “the COVID-reconnect,” and the exes that reach out after months, years, decades.
The understanding of just how tenuous and, yes, precious life is. Saying things that were previously left unsaid. Facing truths we’ve buried for years. Liberating repressed feelings. Recognizing, truly recognizing, what is genuinely essential: relationships, time with our pets, love. Clean air.
This slowing down and looking beyond our four walls is, in many ways, an invitation for all of us to reflect on the resources we take for granted, from being able to walk into a restaurant to access to health care, which should be a basic human right but is highlighted and made personal when children without insurance die from COVID-19.
(True, this happens every day, but it takes a prevalent health threat for the injustice to make the news.) It’s made the invisible threads that run through our food systems visible, and urged dominant culture, and, hopefully, those against immigrant rights, to recognize that migrant farm workers and grocery store staffs are indispensable. For me, the pandemic has been a reminder to appreciate the pantry of healing tools I’ve gathered over the years to manage crises and emotionally-challenging states, which not everyone has access to, either.
It’s terrible it’s taken such a dramatic upheaval for this to land anew in an indelible way, but there is rarely change without loss and seldom an awakening without a catastrophe. My hope is that these lessons will deepen and expand, for myself and others. Will those who are less easy to rattle come out of this with greater empathy for people with OCD and chronic anxiety? More gratitude for those who serve us? What can we gain when we acknowledge what we’re losing?
“Emotion needs motion,” says grief specialist and author of Finding Meaning: The Sixth Stage of Grief, David Kessler. When we pause to identify the ways we’ve been dysregulated and experience the grief we’re feeling, we make room for integration and, ultimately, the fifth “stage” of grief, acceptance.
Personally, I am getting familiar with surprising shades of anxiety and I thought I knew all the hues quite well. The first two and a half weeks of quarantine I feared I had a mild case of COVID-19. Turns out the burning in my lungs and the feeling that someone was standing on my chest in a pair of high heels—which typically emerged after reading the news and went away when I took walks—was a humbling case of anxiety.
And yet, at the same time, I don’t want to forget these sensations. They exist to remind me that to go back to what we know and how we’ve always been would be a huge missed opportunity. It erases the possibility to learn and realign ourselves with the values we’ve lost sight of in our daily hustle. It diminishes what we’re unearthing about ourselves:
That we’re capable of change, even if we tend to resist it, or deem it too hard to even think about. While a crisis isn’t an ideal time to make big decisions, it’s also a chance to assess what we want and make choices we’ve been reluctant to address, whether it’s leaving our partners or changing our jobs or moving out of the country. And it’s a chance to realize that we can let ourselves be impacted by one another’s vulnerability without the fear of being “infected.”
In this slowing down, I’ve been in the practice of crying. Despite spending a good portion of my pre-CV life in mindfulness, I didn’t always make time to grieve. Oftentimes, it would take a migraine to stop my own boundless aim for maximized productivity. I have cried every day this past week, and I’m frequently surprised by the losses, big and small, that prompted it:
Not being able to pet a stranger’s dog, watching characters in a movie embrace, a client expressing her gratitude for my virtual guidance, my dog’s head in my lap, healthcare workers who are putting their lives at risk, giving up an office I’ve worked out of for twenty years.
Even on my best day last week, after meditating in the morning and taking Toshi for a walk, I couldn’t not cry. I “attended” a virtual dance class midday and stretched my arms overhead and arched to the side. It allowed boulders of fear to be shaken loose and shift out of the way. A river of grief flooded out in its wake.
I didn’t try to stop it, or ignore it with email, a Burpee, or a panic snack. I let myself fold forward and sob. Then I stood up, and kept dancing.