Hope, Not Happy Talk, Is the Best Medicine for COVID

Today, I focus on two kinds of hope that can be helpful in dealing with COVID-19. Hopefulness is the noun form and refers to the character strength of hopefulness. One of the oldest references to hope is an island in the middle of a wasteland. This form captures hope as a way of being. Hope may also refer to a verb, an activity. We resort to hoping when we desire something of value that is difficult to obtain. The second ancient reference to hope is a stepping stone to a higher elevation. This form of hope addresses the daily “work of hope."

We may have to wait three to six months before effective COVID-19 antivirals materialize and 18 months before a safe vaccine can be widely distributed. We do not have a definitive answer as to whether a single exposure confers lifetime immunity. We may see social distancing guidelines extend well into 2021, or even 2022. The virus may return in the coming years.

Nevertheless, the vast majority of the population will survive. We possess an immune system. We can protect ourselves. There are amazing professionals around the world, working on treatments. At least 20 different vaccine trials have begun. This is not the Middle Ages when the black death wiped out nearly half of Europe’s population.

Hope is the best medicine because it permits the consideration of both positive and negative information, realities and possibilities.

In a classic article on stress and coping, psychologist Susan Folkman suggested that hopefulness may operate as a background strength to assist with the process (of hoping) when challenges arise. This makes intuitive sense. Nevertheless, for practical reasons, we might separate the island from the stepping stone, and consider ways in which each form of hope may be independently strengthened. If pushed to offer a medical analogy for these two forms of hope, I would compare hopefulness to the immune system, and hoping to a set of healthy habits. Both are important. I will begin with hopefulness.

The Island in the Middle of a Wasteland

The development of hopefulness is the emotional equivalent of a vaccine that confers “broad-spectrum” immunity. This is how I describe a recent study completed in our hope lab, funded by an NIH grant, to deliver hope-building workshops for youth to inoculate them against depression, anxiety, lack of self-respect, and social isolation.

The allusion to hope and “immunity” is not merely poetic. If you review the mind-body literature in depth, there are countless empirical studies, linking each of the four elements of hope to physical health (attachment is another name for “social support," survival is “emotional regulation,” mastery may appear as “control,” and spirituality as “transcendent purpose”).

Regardless of one’s circumstances, it is possible to become a more hopeful individual. Begin today to examine your own present capacities (or deficits) in the domains of attachment, survival, mastery, and spirituality. The medical profession suggests a variety of regular self-examinations for both men and women. Here is mine for hope (with essential hope sub-components in parentheses).

A Self-Examination

Attachment (openness, trust, connection): Trusting relationships are fundamental to hope. For Erik Erikson, the first task of life was to develop trust in the presence of a predictable and benign universe. The successful resolution of this challenge would result in a general sense of hopefulness. Philosopher Gabriel Marcel referred to trust and openness as the fruits and pledges of fundamental hope. Whom do you trust? How freely can you self-disclose with those in closest proximity to you? How often do you feel forced to repress your true feelings, to limit your contact, or slide into deflection to avoid conflict?

Survival (reality surveillance and reality construction): Theologian William Lynch noted, “the further hope would soar, the deeper it must plunge into facts”. Franklin Shontz and Beatrice Wright coined the term “reality surveillance” to describe specific grounding strategies employed by parents of children afflicted with life-threatening illnesses. Real hope requires data gathering and creativity. Denial or false hope are devoid of fact-finding. Cynicism lacks imagination. Ask yourself: Can you shuttle back and forth between surveying and dreaming? Can you find a way to blend reality and fantasy to narrow the distance between your zenith and horizon?

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Mastery (validation and inspiration): Hopeful mastery does not entail a specific goal or fixed expectations about a particular outcome. Real hope derives from an overall sense of competency, one or more external sources of inspiration, and empowering self-other complexes (tethered identities). Some of these concepts were anticipated by the psychanalytic self-psychologist, Heinz Kohut. Who validated you as a child? Whom do you rely upon to mirror your strengths? Who are your heroes? What do you represent that is “great and good” and what (or who) is the origin of that inspiration?

Spirituality: (sacred: presence, assurance, or empowerment): Faith is essential for hope. By faith, I mean centers of value, a concept developed by Psychologist James Fowler. Faith may be religiously based, religious and spiritual, or spiritual but not religious. Which of the following centers of value speak to you (select all that apply): God, a non-specific higher power, nature, humanity, art, science, technology? Which of the following spiritual types describe your way of being in the world (select all that apply): a follower who desires structure, an independent seeking control, a collaborator, a mystic who craves connection, a reformer dedicated to social justice, a sufferer in search of healing?

A Stepping Stone to a Higher Elevation

The process of hoping may be compared to health-habits designed for self-care. The same four elements require attention: attachment, survival, mastery, and spiritual needs. The metaphor of a “stepping stone” pertains to all four elements, for all four can bring a sense of elevation, an emotional lift.

Hoping for Attachment

Hope is fueled by trust and requires a degree of openness. You cannot let social distancing lead to emotional distancing. Hope dies in a silo. Develop a list of individuals you deeply trust and make plans to contact them. However, before you talk, chat, text, etc., consider both your overlapping values and areas where you may not be in complete agreement. Steer towards common ground. In my book Hope in the age of anxiety, I list the qualities of a good hope provider. Seek out these individuals and stay clear of “dream-killers”. The best hope providers demonstrate: availability, presence, and an ability to make contact. They make themselves available by providing access, being reliable, and anticipating your needs. They are present because they focus, offer a safe space, and radiate authenticity. They make contact by fully immersing themselves in the experience of connecting, by demonstrating clarity of intentions, and by offering continuity in the form of valued rituals.

Hoping for Survival

Reality surveillance and reality construction are interrelated processes. Emerging research on future-oriented, mental time-travel highlights the important role of memory and past experiences in generating images of days to come. Those who practice greater mindful awareness, as described by Harvard psychologist Ellen Langer, are better equipped to fashion more adaptive and creative future landscapes. Courage is an underappreciated prerequisite for reality surveillance. Many individuals limit their intake of information to left-leaning or right-leaning media that align with long-held beliefs or attitudes. In effect, they have chosen a “one-dimensional” view of the world. With courage, they might venture to look sometimes through the left-side, another time through the right side, and like the binocular human visual system, emerge with a deeper perspective. In their classic study of children with life-threatening illnesses, Wright and Shontz listed a number of reality grounding strategies designed to facilitate the hoping process. Four tasks appear readily transferable to the current pandemic: taking responsible action (self-explanatory), reflecting on personal assets (age, health, life-experience, social support, etc.), placing faith in growth forces (the power of maturation), and appreciating favorable environmental conditions (warmer weather, new testing sites, etc.).

Hoping for Mastery

Mirroring and idealization are not my ideas. They originated with Heinz Kohut. However, after studying hope for three decades, I have yet to find a better way to capture the quality of hopeful mastery. Switching from hopefulness to hoping, the first task is to secure validation, the second is to gather inspiration. One way to organize your thinking regarding the validation process is to use several of the categories proposed by Gordon Allport to define the multi-faceted nature of the self-image. I like these six: bodily self, achieving self, extended self (possessions and concerns), public self, coping self, and striving self (purposes and long-term goals). You can use this list to reflect on your assets, or you could create a matrix and align each self-construct with a particular individual to contact who can mirror (validate) this part of you. This exercise can help to offset endless ruminations about personal vulnerability to COVID-19. You are more than a wary immune system hiding from an invisible enemy.

Inspiration can come from many sources. History is a natural place to look for tales of courage and determination. If you prefer a structured exercise, create a list of the following characters (representing different strengths): the persuasive salesperson, the book-smart achiever, the entertainer, the explorer, the worker, the artist, the helper. Select three characters you identify with in terms of your own strengths and passions. Who has mirrored these abilities in you in the past? Now identify three role models whom you find inspiring, taking into consideration any of the seven characters. Finally, write three paragraphs, one for each role model, describing how you might translate their example (e.g., work ethic, creativity, humility) into larger lessons to further elevate your commitment and performance, in your areas of strength.

Hoping for Spirituality

My preferred spiritual practice is organized around separate left-brain and right-brain activities for each of the six spiritual types described in the previous section. For diverse client groups, I replicate this two-by-six table seven times, offering one version for each of the major world religions. You can create your own version of this exercise. Identify your spiritual type (independent, mystic, sufferer, etc.) and focus on your religious system (Christian, Jew, Muslim, Native American, Hindu, etc.). If you are not religious, what is spiritual to you? Is it science, nature, or art? On a piece of paper, draw a table with three rows and three columns. For example, you are a mystic but not religious, and “nature” lies at your spiritual center. From left to right in the top row, write: Left-Brain, Right-Brain 1, and Right Brain 2. In the second row, from left to right, write Reading, Music, and Immersion. To complete the third row, from left to right, you will need to do some research. Find passages to read that align with your spiritual center and spiritual type (Left-Brain), then find an appropriate piece of music for your type and form of spirituality (Right Brain 1). Lastly, plan one immersion experience, actual or virtual (Right Brain 2). If you selected nature, plan a walk or a bike ride, or use your phone, computer, or television to immerse yourself in a forest, lakeside experience, or mountain expedition.