Under-reaction AND Over-reaction Are Adaptive in the Short-term
Whitney H. Mitchell, MD
When news hit that COVID-19 had crossed the ocean and was settling into our major cities, each of us internalized that news and reacted differently. Some appeared unfazed by the growing pandemic, continuing daily life as though nothing had changed. Others reacted fearfully and immediately, vigilant of coughs and sleepless with worries. As each of our brains attempted to integrate this new information, some of us ignored the threat, and some of us reacted prematurely.
Denial is one of our earliest-acquired coping mechanisms, and it is a powerful tool. When used for the short-term, denial keeps us focused on the job at hand. If we refuse to acknowledge the seriousness of the situation, we can keep those pesky emotions like fear or sorrow out of our awareness. Denial is useful; it is the coping mechanism used by doctors operating on their patients and homicide detectives investigating a crime. It is that feeling of disbelief that our deceased loved one just stepped out for a bit and will be home any minute. If we can trick our brains into believing that a stressor does not exist, for a time we can manage our emotions so that our brains can focus on the task before us.
Denial fails to be adaptive, however, when our refusal to acknowledge a risk makes us fail to act on our own behalf. Denial at its worst can keep us from going to the doctor when we know that something’s wrong or refusing to acknowledge that our out-of-control teenager needs help. Today denial may manifest as refusing to acknowledge the dangers of Covid-19 and the need to use social distancing. Remember the beach-goers over spring break?
If denial represents the under-reaction, then the adjustment reaction is the over-reaction. Adjustment reactions begin earlier than necessary. Prompted by a fight-or-flight response, the adjustment reaction as a rule is out of proportion to the immediate danger. We become over-vigilant or illogically avoidant. After 9/11 many people obsessed over the news and became wary of foreigners; after SARS some avoided Chinese food in a misinformed attempt to stay safe. The adjustment reaction doesn’t have to be logical and frequently doesn’t make sense, but it is our brain’s best attempt at keeping us safe using the tools it has: loose associations.
The adjustment reaction may not be an adaptive strategy for an immediate crisis, but for insidious stressors that call for eventual action, this initial over-reaction can actually be helpful. As we prepare for approaching danger, our immediate over-reaction acts as a rehearsal. We get to practice our reaction, and when the anticipated stressor finally arrives, we are better prepared. Our rehearsed reaction becomes more logical, more thoughtful, and more intentional so that we are able to appropriately react when it counts.
As we each prepare for what Covid-19 might bring, an emotional response is inevitable. A recent poll by the American Psychiatric Association revealed that most of us are anxious, whether by concerns about health or finances or public policy. Our responses will be widely different based on the coping strategies that we’ve learned and used in the past. Some of us will use denial, and some of us will experience adjustment reactions, but we can be assured that our initial reactions will give way to a strategy that is more useful, more focused, and more adaptive. In the meantime as we give our brains the time they need to process, let’s stay home.
Whitney Mitchell, MD is a physician in New Braunfels, Texas. She is a diplomat of the American Board of Psychiatry and Neurology and has been in private practice for 11 years.