COVID-19 Pandemic, Social Distancing, and Adolescence

Youngsters' difficulty complying with severe limits to in-person socialization.

Posted Mar 21, 2020

Many experts have noted that social interaction among non-symptomatic as well as symptomatic people greatly increases the transmission of the COVID-19 virus in the general population. In addition, it has been recently found that younger people, as well as older, are falling ill with COVID-19. Clearly, social distancing by all of us (in addition to sanitary precautions) is the best technique to limit the spread of the pandemic. Yet, adolescents and young people are not all complying with these injunctions.

Why is social distancing such a problematic recommendation?

Interpersonal connections are the hallmark of human life. Connections with other people promote the development of resiliency and more adaptive defense mechanisms. In times of crisis and stress, people tend to rely on others with whom they are close: family, friends, colleagues, peers, community buddies, and others.  In this time of stress, we are fortunate to have a variety of telecommunications to maintain these close connections, though of course on a modified basis. Terror management theory can help us understand the source of our problems during this crisis.

Terror management theory (TMT)

Terror management theory (TMT) was developed by Ernest Becker in his 1973 book, The Denial of Death. This work was influenced by Freudian as well as other ideas.

TMT postulates that humans have to deal with unconscious signals connected to mortal threat. TMT posits that the unique unconscious (and conscious) awareness of death and tragedy renders human beings prone to debilitating terror. People manage this terror and modify their anxiety by feeling better by themselves as a result if reinforcing their sense of connection with their cultural group. Although Sigmund Freud did not elaborate on the power of death anxiety, he did remark in the Interpretation of Dreams that “Children know nothing of the horrors of corruption, of freezing in the ice-cold grave, of the terrors of eternal nothingness—ideas which grown-up people find it so hard to tolerate, as is proved by all the myths of a future life” (page 254).

In other words, when humans are faced with a very threatening situation, especially one where there is uncertainty about the future, they will utilize a variety of defense mechanisms. Most importantly they increase their closeness with people and groups with whom they feel protected. This close connection bolsters people’s sense of safety and the ability to feel better about themselves. TMT has been validated many times. An important scientist in this area is Sheldon Solomon from Skidmore. In The worm at the core: On the role of death in life, Solomon and his colleagues review experiments validating TMT. They describe how “our unconscious fear of death powers almost everything we do.”

COVID-19 and TMT

Norman Straker has written and spoken about the importance of terror management theory in the treatment of cancer patients with "death anxiety." In a podcast (“How Psycho-Oncology Informs an Approach to the COVID-19 Crises”), Straker discusses how TMT explains our nation’s reaction to the conscious and unconscious “death-anxiety,” which is spreading now in our nation. In such a moment, society needs leaders who are honest, direct, supportive, and do not demonize others. A unified approach on the part of leaders helps the population avoid “splitting,” that very maladaptive defense mechanism, which often occurs when adults do not have a united front with their children. One parent becomes the “good guy” and the other the “bad guy.” This can only lead to confusion, anxiety, and problematic reactions in the child. In times of stress, with a great deal of death anxiety, all of us can feel like children looking up to our leaders as parental figures. When political leaders focus on mutual recriminations, anxiety in the populace increases.

Social Distancing, Social Distancing, Social Distancing

This repeated cognitive message is not working with many adolescents and young adults. Although we are fortunate to have a variety of telecommunications that allow us to stay in touch, too many adolescents and young people find these media inadequate. Why?

Developmental Tasks: Identity and Group Formation and Action

During adolescence, the young person solidifies his or her sense of identity (who you consider yourself to be). Peers and groups are very important and play an important role in the development of the young person’s sense of who he or she is. In addition, the use of action and “acting out” during adolescence is ubiquitous. Action can both express as well as protect against the awareness of intense feeling states which are difficult for the adolescent to put into words (verbalize). In particular, action or “acting out” occurs when the adolescent cannot tolerate feelings of weakness and fear. Abuse of drugs, for example, can be an expression of many complicated feelings during this time and an example of potentially self-damaging experience. As a result of adolescents’ propensity to action and need to be among peers, telecommunication may not be enough.

Of course, one expects the adolescent to desire connections with people outside of his or her family: an attachment to leaders and attachments to groups of peers. However, even with these attachments one also expects a continued connection with the family. Even though they may seem to be devaluing their parents, parents remain very important to adolescents.

Why repeated exhortations do not work for adolescents and other young people

Feelings: As a result of an adolescent's need to avoid feeling overdependent on his or her parents, he or she may revolt against the parents' values, may stop respecting and admiring the parents, and instead express contempt and derision towards them. In such states, the adolescent may act in a counter-phobic way (carrying out a dangerous action just to prove that he or she is not submissive to parental or governmental rules). Other adolescents, especially ones who can be conscious of anxious feelings, may talk with their parents or others and rather than exhibit counter-phobic behavior may be quite eager to talk.

The brain: The connection in adolescence between subcortical regions and the cortical regions in the brain is important to bear in mind. There may be a non-concordance in the development between the different areas.  For example, several researchers have posited a ‘developmental mismatch’ or ‘imbalance’ between neural systems supporting emotional reactivity and regulation, such that during adolescence the development of prefrontal regions lags behind that of limbic structures such as the amygdala, ventral striatum (VS) and orbitofrontal cortex (OFC). As a result, during the time lag in functional maturity between prefrontal and limbic regions, adolescents are less effective at regulating their own emotions and are more affected by emotional context (e.g., peer influence) when making decisions.

Risk-taking behavior: As a result of both psychological and neurological factors, risk-taking behavior is the biggest problem in adolescence and emerging adulthood. For example, data from the Centers for Disease Control and Prevention (CDC) speaks to the dangers for young people. CDC reports that in 2017, the leading cause of death for the ages 1-44 was unintentional injury (the number of which rises at age 15). The second leading cause of death for ages 10-34 is suicide, with a peak at 15-34; and the third leading cause of death for the ages 15-34 is homicide, the peak for that event (Lindsey, et al, 2019).

So what can work?

Given all of these factors, it is no wonder that too many young people do not respond to direct appeal to their cognitive functions. As many development psychologists since Jean Piaget have demonstrated, adolescents’ cognitive development explodes during this developmental phase. These cognitive skills flourish during times of calm. Stress promotes a variety of neurological and psychological changes and cognitive skills may temporarily diminish. The subcortical areas may overwhelm the cortical functions. Adolescents then respond in a way to minimize their unpleasant emotions by utilizing maladaptive defense mechanisms (or implicit emotion regulation techniques) such as counterphobic responses.

Parents and other adults should minimize cognitive techniques. They may feel coercive to the young person, that is, the young person may feel like he or she is “being forced” leading him or her to assert his or her autonomy by saying, “No way.”

Instead, it would be more valuable to engage the adolescent or young adult in an intellectual discussion about the problem. Questions should be addressed in such a way to promote the young person’s sense of autonomy and to communicate that the problem is for him or her to evaluate the risks and dangers, while the ultimate decision is his or hers.  

References

Becker, E. (2007). The denial of death. Simon and Schuster.

Solomon, S., Greenberg, J. and Pyszczynski T. (2015). The worm at the core: On the role of death in life. Random House

Straker, N. (2020), http://ipaoffthecouch.org/2020/03/17/episode-40-how-psycho-oncology-informs-an-approach-to-the-covid-19-crises-with-norman-straker-md/

Lindsey MA, Sheftall AH, Xiao Y, et al. (2019). Trends of Suicidal Behaviors Among High School Students in the

United States: 1991–2017. Pediatrics 144(5): e20191187