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Repairing Social Interactions in a Time of Isolation

Interview with Drs. Livio Provenzi and Ed Tronick on isolation.

Livio Provenzi, used with permission
Source: Livio Provenzi, used with permission

COVID-19 has caused most of us to lose physical contact with other people. We are not able to regularly visit, hug, or converse with those we care about face-to-face. What effects does social isolation have on us and how can we work to mitigate these challenges?

Livio Provenzi, Ph.D., is a psychologist and psychotherapist. He is a researcher at the Child Neurology and Psychiatry Unit of the Scientific Institute IRCCS Mondino Foundation (Pavia, Italy).

Ed Tronick, used with permission
Source: Ed Tronick, used with permission

Ed Tronick, Ph.D., is a developmental neuroscientist and clinical psychologist. He is a Distinguished University Professor of Psychology at the University of Massachusetts Boston and Research Associate at Harvard Medical School. He is co-author with Claudia Gold of The Power of Discord: How the Everyday Ups and Downs of Relationships Are the Secret Building Intimacy, Resilience, and Trust.

JA: How would you personally define isolation?

LP & ET: Isolation—especially when it is caused by environmental conditions outside of the individual’s will—can be a major source of stress for human beings. For example, we know from clinical and research evidence that isolation in Neonatal Intensive Care Units is a source of tremendous distress for the preterm newborn baby—who needs parental close contact—as well as for mothers and fathers, who may suffer from being separated from their infant.

As it is for infants, it is very much the same for children and adults. Interactions with others are critical to emotional functioning and other processes such as attention and cognition. During COVID-19, people have been isolated from their significant ones who were being treated in intensive care units, causing attendant fear of loss, very limited opportunities for connection, and partial or null update on their health conditions. The mitigation and containment strategies needed to deal with COVID-19 have mostly resulted in physical isolation. While technology at least grants virtual social contact and emotional connection, it remains unclear if these are sufficient.

JA: What are some ways we can deal with isolation to become more resilient?

LP & ET: Research conducted with mother-infant dyads from the early 1970s suggests that social discord is not a rarity. Rather, our common and daily social interactions are interspersed with many moments of interactive disconnection. It is through the shared experience of disconnection and, critically, its repair into re-connection that the parents and the newborn can learn how to trust one another and gain a sense of self and resilience. Louis Sander—who can be considered the father of infant research—used to refer to this opportunity to learn emotional reconnection by repairing social ruptures with the term “open space.” An open space allows for co-creating new ways of being together out of the messiness of disconnection. We believe that while an open space is especially valuable for growth and expansion during the first months and years of life, it is equally critical to adult relationships for negotiating creative and shared emotional regulation exchanges in our daily social interactions.

JA: What are some ways people can cultivate relational reparation of isolation amidst this pandemic?

LP & ET: We can see examples of relational reparation of isolation in the media: families writing “everything’s going to be alright” on windows and walls; people singing together from balconies trying to find a sense of attunement that is intrinsic in music; young students collecting shopping lists from elderly people to help them with groceries. Engaging in actions of repair leads to an expansion of the sense of self, a growth in their state of consciousness, and a feeling of connection.

JA: Any advice for how we might use these tools to support a friend or loved one struggling with a difficult life situation during COVID-19?

LP & ET: We would say to the person, give up the fantasy of the perfect relationship. All interactions are messy. Nonetheless, we think searching for relief in the little things may be a way to gain back resources for emotional resilience and psychological reparation. Personally, we have found ourselves reconnecting with friends we had not seen or talked with for years. These were brief but intense emotional moments: connecting with a friend who recently had a baby or helping my mother understand how to use FaceTime and enjoying her reactions. These little moments can fuel emotional reparation and resilience even during intense isolation, and they can foster a sense of connection and well-being.

JA: What are you currently working on that you might like to share about?

LP: The COVID-19 emergency has largely redefined the research agenda of many scientists. I recently published a paper on the way COVID-19 is going to affect the relationship between science and the public. In general, I am working on a large, multi-centric project on the effect of COVID-related stress during pregnancy in women living in the northern Italy hot-spot of initial virus outbreak in Europe. More than 10 neonatal units are involved, and we will collect both behavioral and epigenetic markers of stress in women and infants from the delivery to the end of the first year of life.

Moreover, I am coordinating research on the transition to video-conferencing support for parents of children with disabilities. These families have been highly impacted by the COVID-19 emergency: The lockdown of rehabilitation services has found many hospitals and outpatient centers unprepared. As such, these parents were left alone in taking care of kids with complex health care needs 24/7. This is an opportunity to increase the flexibility of rehabilitation programs in case of future epidemics, but also to reach families who can only partially access health care services due to geographical or economic constraints.

ET: As a complement to my still-face paradigm, I have developed a mild acute stress paradigm for parents during interactions (Tronick et al., 2020). It demonstrates how even mild stressors disrupt parenting. In ongoing research, we are looking at parents who had a range of COVID-19 stress and evaluating the disruption of their parenting and its effects on their infants. I am also elaborating on my theory of the Buffer-Transducer Model of Parenting (Tronick, 2018) by including the ideas in my book, The Power of Discord. My goal is to reduce the stress parents experience in parenting their children, especially in these very stressful and frightening times.

References

Follow Dr. Livio Provenzi on Twitter and Facebook.

Provenzi, L., & Tronick, E. (2020). The power of disconnection during the COVID-19 emergency: From isolation to reparation. Psychological Trauma: Theory, Research, Practice, and Policy.

This paper was support by grants from the Italian Ministry of Health to author Livio Provenzi.

Tronick, E., Mueller, I., DeCorcia, J., Hunter, R., & Snidman, N. A. (2020). Caretaker acute stress paradigm: Effects on behavior and physiology of caretaker and infant. Developmental Psychobiology, 2020;00:1-10

Tronick, E. (2018). The caregiver-infant dyad as a buffer or transducer of resource enhancing or depleting factors that shape psychobiological. Development Journal: Australian and New Zealand Journal of Family Therapy. DOI: 10.1002

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