Thursday, September 7, 2023

Covid and the Brain


Two slightly different takes from lengthy threads on how the brain operates in such a way that makes it ignore Covid risks as it protects us from the trauma caused by Covid risks: 

First, career coach Lisa Petsinis outlined how we think about Covid and why we aren't acting on it. In a nutshell, our brain automatically protects itself from knowledge of a difficult situation (like we did something wrong) with defence mechanisms until it's ready to deal with it. Getting people to focus on which behaviours feel worse generates a more moral outcome than a focus on which creates the best outcome, but we generally tend to solve any internal dilemma by sticking firmly to one side, and then we hunker down there regardless any new information. 

Petsinis explains,

"The mind can protect from trauma by using mechanisms such as repression, denial, and dissociation. This is helpful short-term to allow you to function until you're ready to process the trauma. Repression can allow you to avoid feelings of overwhelm or guilt associated with them. With unethical behaviour, rationalizing, burying, or ignoring can be coping mechanisms. A leader might convince themselves that downplaying reality is needed to prevent widespread panic or economic collapse, or compartmentalizing it, so they can get on with other business. Acknowledging a crisis' gravity can raise questions about past decisions and avoid blame. How convenient! 

I think this has been a major factor in workplace health and safety, as well. Employers, unions, lawyers, HR leaders, association, insurers--all playing hide and seek.

The mind can also be involved in an unconscious tug of war - the battle between what is right vs what is good for someone or in picking from two horrendous options. Check out the role of the ventromedial prefrontal cortex and the ethical dilemmas at the end of this study."

The original study, in the Journal of Neuroscience, is a culmination of ten years of research that shows how our moral decisions are affected by neural structures by watching people make decisions in an fMRI. Our brain automatically focuses on immediate survival, but parts compete when we have to make choices in "wrenching scenarios." Different parts of the brain lit up when asked for the option with the best outcome (utilitarian - acceptable losses) compared to being asked which option they'd feel worse about doing (deontological). The study's conclusion is that both the amygdala and the ventromedial prefrontal cortex are involved: the amygdala specifically "is associated with the evaluation of utilitarian options as more emotionally aversive and less morally acceptable" and the vmPFC "inherently favoring deontological judgment." So any damage to the amygdala or the vmPFC can lead to greater comfort with letting the vulnerable fall to the wayside. 

The fact that Covid causes brain damage doesn't lead to a very happy ending to it all!! 

I'm interested in the fact that just presenting the question to focus on which feels worse generates a much more ethical response than which has the best outcome. Petsinis focuses on the effect conflict has on our decision-making capabilities:

"When a person experiences psychological discomfort, they are motivated to reduce/eliminate it by choosing one world view and behaviours over the other. Some find it easier to pick their truth - and stick with it. Some old articles that still hold true: "Biden's Covid Prove and Cognitive Dissonance."

'When all the other strategies have been tried and found wanting, I've found myself throwing all my hopes at the big-truth resolution. I follow the evidence then force myself to pick one side and stick with it. This stops cognitive dissonance outright, but then I have to hope that the truth I've picked is also the narrative that society will come to select. In picking one side, I take a risk as my government may lie for 'pragmatic' political or economic reasonss, and this would place me outside or against society. Or more simply, I may have picked the wrong side and may be using confirmation bias to shore up my convictions. I may end up mocked and rejected. Then again, if I stick to 'my truth,' conflict with others may still be better than unresolved conflict within myself.'

How might this apply to masks--even from the early days? From "Masked Intentions: Why Some People Resist Face Coverings":

'The mask is a visible and impossible-to-ignore reminder that what the individual is doing is putting him or herself at risk. So we now have two opposing cognitive forces: on the one hand, the person wants to participate in whatever social activity they have chosen, but, on the other, the mask is 'telling them' they are putting themselves at risk.'

This is faulty framing; masking is an act of care. 

I think this misses the point of the article a bit. Yes, masking is an act of care, but it also is a reminder of the risks we're facing, which is a barrier for many people to fully enjoying themselves when they're out socializing. What works for me isn't reminding myself that masking is caring, but reminding myself that well-fitting masks work to dramatically reduce risk. I can safely socialize with friends again, but only with a mask

Can the human mind be tricked into believing something, such as the pandemic is over when it's not? 

  1. Blame the underestimation of ongoing risk in part on normalization bias. Reduced or biased media coverage doesn't help. 
  2. Confirmation bias contributes to people seeking out information that confirms their beliefs.
  3. Peer pressure is a big factor--especially for young people, but you see it everywhere in workplaces, in conferences, and government houses and school board trustee meetings. If people around are downplaying a situation, others are more likely to do so also.
  4. Living through crisis can be exhausting and the brain is tired, too, and wants to alleviate stress.
But what about the people who ought to know, and who are charged with spending our tax dollars on keeping peopel safe? How do they sleep at night? From "The Psychology Behind Unethical Behavior":
'First, there's omnipotence: when someone feels so aggrandized and entitled that they believe the rules of decent behavior don't apply to them. Second, we have cultural numbness: when others play along and gradually begin to accept and embody deviant norms. Finally, we see justified neglect: when people don't speak up about ethical breaches because they are thinking of more immediate rewards such as staying on a good footing with the powerful.'
How many leaders are jockeying for powerful posts or lucrative private roles?

What can leaders do when they suspect unethical behaviour or realize that they've been colluding or repressing their own participation? Some advice from that article: 
'Start looking out for signs of moral capture: those brief moment when you don't recognize yourself and any other indications that you are subjecting your own personal agency to the deviant norms of the collective. Another regular gut-check you can use involves asking whether you would be comfortable telling a journalist or a judge about what's gong on.'
Please do!

This is Aristotle and Epicurus: Consider the best, most moral person you know and think about what they would do in this situation and how they would react if they saw what you chose to do. 

I am still waiting for someone to step up -- medical experts in the media, government leaders, public health officers. Eventually, no matter the brain's tricks or coping mechanisms, the reality will surface. When it does, humility--the critical and sadly rare quality--will be important. It starts with admitting that you aren't perfect, you have learned, and you're ready to make amends.  Cognitive processes, which not justifying inaction, might offer insights into the complex mental and ethical challenges of our time and our continuing crisis. Holding leaders accountable for transparent, science-based, and ethical decisions is crucial for a safer and healthier future. 

What else can you do?
  1. Stay informed and share reputable sources.
  2. Highlight ethical leadership when you see it.
  3. Remain curious and practice humility yourself.
  4. Join the conversation and create safe and open spaces for dialogue and growth."

I'd add, stop waiting for people to step up. They're too entitled, numb, and neglectful for that! It's on us. So keep wearing a well-fitting mask in indoor public places to reduce the risk and to show your integrity in the face of adversity! Imagine how you'd feel if you didn't and someone got sick because of it.  

Second up, author Stephanie Tait reacts to the position that some healthcare workers are downplaying the risks because they've been repeatedly infected, and are now making bad judgments because of the resulting cognitive impairment. Her position is that it's beyond us to react differently to the trauma of the pandemic until it somehow ends.  

"You don’t need cognitive impairment to explain this, because we are wired neurobiologically to try to protect our minds from trauma - often to the point of cognitive dissonance. Doctors were/are exposed so much that it makes sense they’d subconsciously NEED to downplay the seriousness of Covid to reassure their psyche against the scary informatino coming out more and more about what those repeat infections really mean. It’s a way (not saying it’s a HEALTHY way) to cope with having to continue to be exposed at a high risk job again and again without feeling overwhelmed to the point of shutting down. Seeing all these other maskless people and the government saying everything is fine provides the brain an option that would make it all ok, and cognitive dissonance kicks in to allow them a way to latch on to it despite knowing better. This is why the more people get infected again and again, the more they seem to NEED Covid to be “just a cold.” It’s also why people went so quickly from “you do you” to angry and aggressive towards those still successfully avoiding Covid. Because those people destroy the illusion their psyche is depending on in order to cope. They need everyone to act like Covid is no big deal to keep themselves from being confronted with a reality they are unable to process. 

It’s not cognitive impairment; it’s how human neurobiology works to “protect” us. 

This is also why when folks like me share about the numerous studies showing the long term harm Covid actually causes to try to warn people of the danger, people react by saying it’s CRUEL to share that because it’s mean to scare all the people who’ve already been infected before. Because the brain isn’t actually thinking rationally in a way that looks at what the ACTUAL problem is here. It’s in survival mode, where all other logical processing comes secondary to the primary objective: protecting the psyche from the trauma of a reality too hard to accept. So instead of being angry at the leaders and systems that failed you, the brain sees the PRIMARY threat in that moment as the person disturbing the illusion your brain is depending on to feel safe. THEY are the problem you can actually deal with; the real problem is too big. 

This is part of why I’ve lost hope that things will change anytime soon, no matter how bad this wave and the one coming in behind it end up being. Because even if people COULD see the wave accurately (which they won’t be allowed to, for what it's worth), their brain will fight to disbelieve it. Accepting that Covid really IS a dangerous pathogen that causes serious long term harm means being forced to reckon with not only with what that means for your own body and future health, but it brings much bigger and more difficult questions. Questions like, How many of my infections could have been avoided if I had done X differently, or I hadn’t done Y? How much should/do I blame myself here? Are there people I love that will experience these harms because I infected them? Do they blame me? Do I blame me? Will my children’s lives be shorter and/or full of difficult health challenges because of choices we made for them when they were too going to choose for themselves? Will they grow up to blame me at all for choices I made? Do I blame me?

Right or wrong aside, these are the sorts of questions that the brain would be forced to grapple with if made to see the reality of Covid - which once again provides even MORE cause for the brain to avoid that realization at all costs. It’s too much to take. 

But the number one reason the brain needs to keep fighting against these realizations is the most insidious of them all. Because the trauma is still ongoing. The risk is still happening, and despite the rhetoric of “personal protections” the reality is that no individual on earth has the ability to FULLY control their Covid exposure 100%. And the brain knows this all too well. There’s a reason any trauma therapist worth their salt will tell you that you can’t start work to heal from a trauma that is still ongoing. Because your brain is still in survival mode - still prioritizing protecting you over all else. You can work together on supporting your body and mind through the ongoing trauma as best you can, sure. But you can’t actually work to process the trauma and heal from it while it’s still happening. And that’s the problem here with this pandemic as well. Which creates the ultimate catch-22: As long as people refuse to accept the reality of Covid, they’re going to keep infecting themselves and their loved ones, keeping the pandemic going. But as long as the pandemic is still going, they can’t accept the reality of Covid. And that’s where we find ourselves right now. Which is exactly why I’m not hopeful anything will change until a neutralizing vaccine is available. People are too invested in the lie now. They NEED the lie to keep from having a breakdown. Don’t get me wrong, I’m still gonna keep fighting: my survival and my children’s futures depend on it. But I do it from a VERY different place than I did in 2020-2021. These days I’m painfully aware how much of a Sisyphean pursuit this whole thing is."

Absolutely. 

However...

A commenter mentioned that brain dysfunction due to Covid is also a concern when people start making grave errors in judgement. 

Tait responded:

"Where folks veer dangerously into ableism is when they point to behaviors they don't like and offer conjectures they are caused by cognitive impairments. Be very careful about crossing that line here because I will absolutely call it out when I see it."

I'm not sure where that line is for her, but I might have crossed it already. 

It's clear that many professions are being affected by people no longer able to perform their job because of the physical effects of Covid on their brain and body. I'm not clear why saying the problem is due to physical effects on the brain is ableist, but the problem due to psychological effects on the brain is not. I think they can both lead to ableist reactions and policies, which is a huge problem already happening.

I get the concern with a patronizing view that someone's too dumb to make the right decision. That's shitty and sometimes dangerous. But that's different from watching out for cognitive impairment that we know is being caused by a virus. I stay further back from others when I'm driving now, and I get more second opinions on everything from medical care to my furnace. People are making mistakes in the workplace. It's similar to noticing and becoming attuned to little signs that a loved one is in the early stages of dementia. It can be very tricky to know when to take away the car keys, but we do have to pay attention to this. And we're facing a potential tsunami of dementia-like symptoms in our population. So why wouldn't people working in healthcare be neurologically affected?

Suggesting, as the poster she originally responded to did, that people may not be behaving adequately in the face Covid, in part, because their brain is no longer functioning optimally is no more ableist that suggesting airline pilot issues are Covid related. How we address that, however, could be ableist if we're not careful to ensure the rights of all people with disabilities. 

But one thing we can do is to have some clear safety rules to prevent harm coming to themselves and others. Like we ensure everyone's in a seatbelt on the highway, we could ensure everyone's in a mask in a hospital. 

We just have to be really careful when rules are imposed that aren't about keeping people safe, but start to become about keeping people controlled.

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