‘Too Distressing to Bear?’ Reflecting on the COVID-19 pandemic

Dr. Psych. Francisco Muñoz-Martin


‘Too Distressing to Bear?’: Reflecting on the Covid-19 pandemic: A time of mental health emergency and choosing a deadly ethical position.

In a hospital emergency department, one week before the Covid-19 quarantine, Dr X tells patient H: ‘You are suffering from serious pneumonia and you have tested positive for the strain of flu they are calling Covid-19. I need to admit you right away.’ Surprisingly, patient H replies: ‘Well, doctor, what a relief... I thought it was something more serious... like lung cancer.’ Within three days, patient H dies in the hospital ICU without seeing his family and is cremated alongside others before his children and friends have the chance to organise a dignified send-off.

This situation in which we find ourselves is truly dangerous, unexpected, fast-moving, and tremendously painful, with thousands of human beings facing a pandemic together, with different experiences, attitudes and behaviour during these difficult times.

We find attitudes, behaviour, and responses like that of patient H to Dr X particularly shocking. Dr X, a patient of mine undergoing psychoanalytic treatment, asked both herself and me about what Covid-19 is, and what she had heard from patient H at that time, as well as everything she is experiencing at work and what she is seeing on the television and on the streets. It seems that the hospital patient showed disregard for the situation, as did she, because of an apparent lack of information about and ignorance of the gravity of the clinical situation.

The surprising calm of patient H, as well as the wording of Dr X, comes from a lack of relevant training and information, if not a typical mechanism of psychological denial, caused by a lack of information or an attitude of unconcern and ignorance to the real gravity of the pandemic. Much more concerning and pathological than this is the attitude of those who, when faced with a traumatic reality, use the ‘denial’ mechanism to deal with the cognitive and emotional impact of traumatic events; that is, the denial of suffering and the disruptive reality threatening their lives. Conventional wisdom knows this as the ‘ostrich policy’. This comes from the typical behaviour of these ‘flightless birds’ when faced with truly dangerous situations. They bury their head in a hole to avoid facing danger and to make the threat magically disappear.

Who in their childhood, youth or adulthood has not practised or felt compelled to use denial when faced with situations that intimidate us or when we feel completely powerless?

It is a very human behaviour... but it is very risky to survival when practised too frequently or, in the worst-case scenario, when it crystallises in the personality of countless people. This situation is aggravated when human beings deny their responsibilities, as well as the reality and consequences of their actions, and not only endanger their own lives, but also those of their loved ones.

For those who repeatedly use the denial mechanism, experts of psychopathology and the psychoanalytic discipline have coined the term ‘psychopaths’ or ‘perverse narcissists’. Denial, used as a negation of reality and its consequences, attempts to make conflict magically disappear in the interest of other spurious interests, to hide their selfish desires, their responsibilities, as well as the reality of their actions.

This type of person, with a false psychological balance and a deteriorated moral conscience, projects his own conflicting feelings on others, blaming other people and trying to make them solely and exclusively responsible for the errors committed or the calamities suffered.

The psychopath, or the perverse narcissist, is usually split in two and creates two images of himself to maintain his good image while projecting his bad side outwards to try to get others to deal with it. Some people spend their lives practising the ‘ostrich policy’ by criticising others for their small flaws while ignoring their own larger ones. Unfortunately, this does sometimes result in short-term social success.

The favourite weapons of this type of person are usually words. S. Korff-Sausse (2003) has said that ‘language’ is his real weapon, perhaps more fearsome than physical violence since he uses it to achieve both his goals and the subjugation of others.

There is no need for me to give educational examples to illustrate what I am saying, as it is enough these days to consult social media to observe the behaviour of many ordinary citizens in these times of confinement. Especially the attitudes, opinions, discourses and behaviour of many journalists, political figures, and members of parliament in our country and others during the management of the Covid-19 pandemic.

I believe that all of this lies not only within the confines of psychopathology, but also within the limits of the lack of ethics or, rather, within the space of a decomposed, degraded sense of ethics, which does not pursue the common good but instead, consciously, or not, the spurious, illegitimate, adulterated, fraudulent and deadly benefit of each individual. 

Korff-Sausse, S. (2003): Handicap: l'éthique dans les pratiques cliniques (Connaissances de la diversité) (French Edition). Toulouse: Edit. Érès.

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