Pain patterns: what Covid-19 can teach us about how to be human | Life and Style


WWhen the closure began, the bodies on television confused me. Why were they not distanced socially? Didn’t they know not to be that close? The mandate to be separated was unknown and irregular, and for me, isolating yourself alone, following this government directive was peculiar. It made watching dramas and shows produced under normal shooting conditions feel jarring.

Seven weeks later, the disjunction has passed. I, like all of us, am adjusting to multiple bodily realities: single bodies, distant bodies, bodies in the park to avoid, bodies of disobedient young people who gather in groups, bodies in rows outside shops, bodies and voices flattened on screens and above all, bodies of dead health workers and caregivers. Black bodies, brown bodies. Working class bodies. Bodies that are not normally praised are now celebrated.

We are learning a whole new label for bodies. We deviate from each other, jump onto the nearly empty street, calculate distances at park entrances, avoid body contact, including eye contact, and monitor those who are glued to their phones, whose inattention threatens to violate the two meter rule. It is strange and puzzling and is not second nature.

Until the pandemic struck, many of us were finding the most appropriate text messages, emails, and Whatsapp for our fast-paced lives. But now we are going to reuse the phone and enjoy the sounds in our ears and the rhythm of the conversation, instead of feeling rushed and interrupted. Some of my psychoanalyst sessions are now done over the phone, but for the most part, I spend my time looking at a screen and seeing faces instead of whole bodies. Until I learned to turn my eyes off myself, I, like others, was baffled by the weirdness of seeing myself, a sight I don’t think we should see.

Neighbors from social distance in Syracuse, New York.

Neighbors from social distance in Syracuse, New York. Photograph: Maranie Staab / Reuters

Conversations in therapy challenge many of the customs of social relationships. There are silences, repetitions, reformulations, links through time, reminiscences of fragments, precipitations of emotion, fragments of dreams, things told and then rejected. There may be restlessness or absolute stillness. These form the idiosyncratic and personal environment between each therapeutic couple. As a therapist, I am also alert to how the dilemmas that plague the person or partner I am seeing are brought into our relationship.

The puzzles that prompted the person to seek therapy in the first place can be reproduced here. For example, a person fearful of intimacy may experience the therapy relationship or the therapist as too close. Someone else who worries that they are too needy may be reluctant to show their wishes directly to the therapist, although they can talk about how they are doing poorly in other relationships. The therapeutic relationship and sessions are our Petri dish. The field of study is the human subject (and its ways of being able to develop and change).

The therapist works to understand an individual’s personal psychological grammar, to help the person run the risk of unlearning, and then to learn again, finding ways not to suffer as much harm. So also with the body. Those with troubled bodies bring them to the session. They may sit too close, for example, or look concave, or dress incongruously, as if they were introducing a different person at each session. In the course of therapy, such an abject body experience can be addressed, and by unlearning and then learning again, the person finds a more comfortable way to sit in his body.

How does the dematerialization of bodies affect us and will it affect us? Me, my patients, you, all of us? For some of my patients, their screen or home is a prison. His experience is full of grief and concern. Therapy keeps them almost on the verge of sanity, but it is a sanity that hurts: isolation can prowl us all as we miss the interactions, intimate or casual, that confirm our sense of our value, our place in our community, our work. and the world.

SSome of my clinical concerns focus on how we gain a physical and bodily sense of self. Although psychoanalysis is a theory of the mind and body, its main emphasis has been on the development of the mind and its structures: what we call defenses and the relationship patterns we have absorbed. Bodies have been the protagonists of the main drama of the mind, even when mental processes or alterations have caused bodily symptoms such as eczema or non-biologically induced paralysis. As therapists, we traditionally read the problems visited on the body in our minds, seeing them as a result of mental conflicts. And of course they often are, but I have long been interested in understanding bodily problems and bodily difficulties on their own terms, and building a theory of body development.

Bodies have always been bound and marked by social rules. Different societies have a different meaning from similar actions or body gestures. The variety of body adornments and transformations around the world, from rings around the neck to the recent increase in lip reductions and penis enlargement, has made it increasingly clear that the body is not simply the product of DNA. The body we inhabit develops in relationships with other bodies. Generally, it is within the mother’s orbit where, to take an obvious example, we first apprehend gender-based forms of behavior. When I grew up, being told to sit like a girl and not to climb trees were some of the ways we were treated differently than boys. Research in many cultures shows that girls are weaned and trained to go to the toilet earlier, fed less in each meal and less food than boys. There may not be a biological basis for this, but rather a social and unconscious basis that then informs how we personally experience our particular incarnation.

We have very few verified reports of humans growing up outside of human culture, but the wild boy Victor de Aveyron, who was discovered living wild in the forests of southern France in 1800, had no body movements that were recognizably human. The melee relationship that was critical to him was with the bodies of the wolves he apparently grew up with. Apparently he imitated his gait and movements, his posture and his vocalizations. Of course, we know this in a more familiar and less dramatic way, when young people develop their group identities by adopting the gestures of actors or film musicians.

Social estrangement during the opening of Dragon’s Heart Hospital in Cardiff last month.

Social estrangement during the opening of Dragon’s Heart Hospital in Cardiff last month. Photograph: Matthew Horwood / Getty Images

Through screens, billboards and retouched images, we reduce the wide variety of body expressions. It is as if we are losing body diversity just as we are losing languages. Digitized and westernized body image prevails, and in the last two decades it has generated a cosmetic surgery industry worldwide: from leg lengthening surgery with ribs. steel in China (now banned) to rhinoplasty in Iran (which has the highest rate of nose surgery per capita in the world) for double eyelid surgery and jaw reduction in South Korea. In the west, surgeons sculpt cheekbones, breasts, and calves, and offer daily procedures for facial “line stretching.” Cosmetic surgery resorts in Hungary, South Korea and Singapore thrived until closing.

A Chinese smartphone app allows the self-portrait to adjust your portrait to bring it closer to a very specific beauty standard known as wang hon lian, or “internet celebrity face”. It is very popular: Billions of wang hon lian images are uploaded each month.

The richest Europeans are not in technology, but in the business of beautifying bodies: the owners of fashion, luxury and cosmetic brands such as LVMH, L’Oreal and Zara. Increased automation has led us to move from using our bodies to make things the place and product of our work, through diet and exercise regimes, clothing, and cosmetics. The body of the surface is intended to be on display.

Paradoxically, the body of the other sweating, smelling, hugging and caressing becomes, for those who distance themselves socially, too distant, while for others, such as those who share a house with adolescents, it is too present. Everything is on display for families and housemates, while everything is hidden for those who live alone during the confinement.

The body experience in FaceTime or Zoom contrasts with the pulses, the breathing, the crying, the sighs, the tiredness, the pain or even the elastic and enthusiastic bodies that we inhabit. We no longer have social fellowship in the flesh, the handshake or the hug, the pleasure of eating in a restaurant with a friend or lover while sitting near strangers. Fearful of infection, for our protection, we collapse our social space.

reDuring World War II, psychiatrist René Spitz studied orphaned babies in care. He found that those closest to the nurses’ station thrived, while those at the end of the room did not do as well. The difference was touching: the nurses touched and interacted casually with the people closest to them, and this gave these babies the essential food for physical and psychological development. They absorbed the will to live. A decade later, in research now considered controversial for the way he removed baby monkeys from their mothers, American psychologist Harry Harlow discovered that baby monkeys receiving ersatz mothers in the form of basic cloth puppets would find a crucial safety and comfort even in this simulation of maternal touch; those monkey babies deprived of any kind of maternal contact were greatly disturbed and many died.

Touch, feeling and proximity are essential for survival. Consider the genius of premature babies ‘ability to regulate their own temperature and, remarkably, their parents’ body temperature, if they are kept skin to skin in a bag. The gaze, the search to be seen, recognize and influence the other, is also crucial for human subjectivity. In a fascinating video made by developmental psychologist Edward Tronick, he instructs a mother playing with her baby to keep her face still and refrain from interacting with her baby for a minute or two. We observe how the little girl seeks to involve the mother. When unable to do so, the baby collapses psychologically and physically until contact is re-established. What is so shocking is how fast the collapse is.

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I’ve been thinking about how incredibly difficult and challenging our almost dematerialized life is through the Zoom screen, whether chatting with friends or in a meeting. Conflict and harmony become cartoony as the subtle gestures collapse and the conversations we have with our eyes close.

Reading each other well enough is a new skill in the therapy room, too, for both people. We’re already used to screens and phones, and the occasional glitches. We are looking at a physical interior: a study, a bedroom, a shed, or a kitchen, and we are surprised by an occasional floating child. We hear the suddenly silent voice of someone who does not want their partner to deviate from the conversation we are having. It illuminates aspects that we have not seen before. Is better? No. Is it worse? Slightly. I miss noticing how people enter the therapy room: the subtle difference from the previous session or the way they can hold their face and body; above all, the animated body in the room. I suspect I am more encouraged to make up for the loss of that precious physique.

Former hostages Terry Waite, John McCarthy and Brian Keenan have eloquently written and spoken about solitary confinement and their struggles to find a way back and forth, or should I say, to family and social life. It was hard. And while many of us don’t isolate ourselves, unless one is able to do interesting or valuable work during this period, or have enough people to hang out with, we can expect considerable psychological difficulties as we come out of the close. How will we reestablish social interaction with other bodies? What kinds of rhythms will we want and be able to have in the future?

Seat regulations within a court in Belgium.

Seat regulations within a court in Belgium. Photography: REX / Shutterstock

Many have been very busy with homeschooling, working from home, managing three generations, etc. Time has bent and contracted in bewildering ways. Occupation has increased for some, while for others, for whom the slowdown is a strange concept, idleness has been imposed on them. Empty time feels strange, or at least it did at first. For many it has been an unexpected pleasure. There is no need to rush to social occasions. No need to dress. It is not necessary to do everything and more. Being wanted, being needed, being in demand have been psychological supports that have melted. Finding new ways to nurture one’s needs in this new reality, especially in the absence of touch and gaze, in which we unknowingly trust to recognize ourselves, can be difficult.

Today, there is a frightened, cautious social body. A tense body, in which the key word is avoidance. The face covered in either a hoodie or a veil, which some previously found challenging, now offers peace of mind. In fact, many public places, from Eurostar trains to the streets of New York, Prague, Dubai, Havana and many more, now demand it. Meanwhile, much of society is paying attention to bodies that had been scandalously overlooked. The bodies of working women, caregivers entering and leaving the homes and homes of the caregivers. The faces of a large number of black, Asian and ethnic minority bodies, particularly in the health service, are finally being recognized for their courage, and the surprisingly disproportionate number of their losses.

Before Covid-19, the ruling party was happy to cut health and social funds, put money into administration on the NHS, and not professional caregivers, doctors, and nurses. Society is now awakening to the value of medical care and expertise that comes from the hospital floor – that is, from the doctors and nurses who are reorganizing what is happening there. People who keep society going in all sectors – transport workers, small merchants, food production and delivery workers – are often first-generation immigrants. More people are seeing a more nuanced social picture. The opportunity is here to rethink how we represent the social body. It is necessarily different, and that needs to be recognized, as is the shame of our previous marginalization. Covid-19 is cleaning the lens, so we can see more clearly.

FFrom the individual to the social body, and how the pandemic is challenging it, we turn to the corporate body, the state body, and what we have been learning about how it has worked. On April 17, Professor Anthony Costello, former director of the UCL Institute of Global Health, told the select committee on health and social care that he feared Britain could have the highest number of deaths in Europe, which has now been confirmed. Costello had estimated 40,000 deaths; On May 5, the official death toll in the UK was just over 32,000, but the Financial Times reported the same day that the actual number had probably already exceeded Costello’s estimate. London and North West England show higher death rates than other regions, while according to the ONS, people in the most disadvantaged areas of England and Wales die twice as much as the richest areas.

Costello advocated this figure because we were slow to take preventive measures from the beginning. He spoke to committee chairman Jeremy Hunt, who has spent this apparently stressed period due to a lack of evidence, fans, and PPE equipment. This is the same Hunt who, as the longest-serving health secretary in British history, also had social care in his portfolio and the pay of doctors, nurses and social workers. Even more damning, it was the minister in charge during Exercise Cygnus, the UK government’s drill to test our preparedness for a pandemic, conducted in 2016.

The full review of Cygnus exercise has never been officially published, but leaks have revealed that it showed that the UK healthcare system and local authorities were unfortunately unprepared for such an eventuality. The exercise showed that hospitals and mortuaries were quickly overwhelmed, and the shortage of critical care beds, ventilators, and personal protective equipment for hospital staff.

Cygnus and other similar exercises are meant to show the government what to do to be prepared, which was not, as Hunt was doing, cutting beds. On March 28 of this year, when the Cygnus debacle came to light, we were told that the projections were not remedied due to concerns that beds, fans and PPE would become outdated or outdated and that the government had worked to secure reliable supply chains. (As we have seen, in a pandemic, reliable supply chains overwhelm very quickly.) A report from the 2018 Red Cross Conference on Cygnus and infectious diseases stated: “The financial and human cost of an outbreak can be staggering, and early response reduces the cost. “Our government chose not to act.

Nursing staff applaud at a window inside Queen Elizabeth University Hospital in Glasgow.

Nursing staff applaud at a window inside Queen Elizabeth University Hospital in Glasgow. Photography: Andrew Milligan / PA

The Peace Fund, the Washington-based NGO that publishes the Annual Index of Fragile States, lists the criteria for a failed state. I believe that we have come dangerously close to meeting two of its criteria: the inability to provide public services for the poor and the inability to interact with other states as a full member of the international community.

As the absurd developments of recent months show: the question about the independence of the Scientific Advisory Group for Emergencies (Sage), the alleged lost communications with the EU about PPE, the political decision not to cooperate with the EU, the publication of evidence without return envelopes and expiration dates for PPE equipment: The government is located in the territory of Fawlty Towers.

Plans for British companies to design new ventilation machines, detailed by the Financial Times, fell apart. Our government chose to generate new ideas instead of developing the existing plan under license. Why, one should ask? Could it be the arrogance of Brexit?

I do not want to contrast the UK’s response with that of the EU, because the latter has not always been covered in glory during the pandemic. The ethics of cooperation in Europe and the ethics of transparency and honesty have been strongly tested in recent months. Perhaps now, however, the joint project of the European Investment Banks and the WHO can encourage us to boost global health systems. Will the UK state contribute? I do not think so. Much depends on the actions of citizens now to move forward. From this point of view, it is encouraging to see the formation of a new independent panel of experts, a “rival” to Sage, led by former chief scientific adviser to the UK government, David King, whose deliberations are on YouTube for the let’s see.

I’m not sure how we characterize the state’s next failure, because it’s partly the expression of the public good: Of the 750,000 people who signed up to help the NHS, invited by the government, fewer than 100,000 have been deployed. As citizens, we want to contribute. This waste of people’s generosity is disturbing. Fortunately, people like Captain Tom Moore or the many masks and 3D printers that continue to work continue. And the Feed NHS program, in which the Leon restaurant chain and other chefs are preparing to feed patients, doctors, nurses, hospital porters, and ambulance workers, is now on the train. This voluntary work, in which groups of people organize themselves, is outstanding and yet contrasts with the inability of our state to mobilize those who wanted to help.

The Gates Foundation’s contributions to seven different vaccine programs, and Twitter CEO Jack Dorsey’s donation of $ 1 billion, are impressive. They will cover funds in the UK, such as Ruffer Investment, which pocketed £ 2.4 billion in March, or Somerset Capital (the fund that Jacob Rees Mogg used to manage) that see Covid-19 as an investment opportunity “once or twice in a generation, “make a contribution too?

There are several dozen UK-based hedge funds that manage assets worth £ 1bn or more. Could the mood of the country be such that hedge fund investors and managers can be persuaded to donate some of their obscene profits to the coronavirus response or to sponsor immigrants from beyond Europe (who work here as cleaners, caregivers, drivers), who do not earn the £ 30,000 currently required for a work permit

COvid is a sad story. It is also a story of resilience. The body of state has failed us. We need to grow and recognize that. Covid-19 has exposed an unforgivable systemic failure. In the years leading up to this, we have seen a decline in the status of public officials and a degradation of health workers. We have seen teachers, doctors, and academics hidden in a managerial economy. At least it appears that micromanaging has been temporarily revoked in hospitals, thank goodness, because right now doctors and nurses need to be running the program.

And to return to our bodies, the living, so many devoid of touch and gaze, faced with a long period of isolation and scared. How can I conclude?

In a way, I can’t. We are far from the other side of this crisis. Psychological therapies will play an important role in rebuilding the body and soul. I don’t really like the word trauma, because it has been used too much, but we are a society that is in trauma. A social trauma provides opportunities for people to go through things together, rather than suffer alone, as long as we do not bury or clarify what we have experienced and continue to experience. We will have to find new ways to live with our fears and discomforts, overcome the social phobias Covid coined, with what we project into other people’s bodies and the fears we have about our own vulnerabilities. We will need all the help we can get to reshape our relationship with our bodies and those of others, to find a way to build bonds of attachment and respect.

What started with the dematerialization of the individual body has now been transformed into the dematerialization of the state body. The economist Joseph Stiglitz reminds us that, with the dismantling of the state under Ronald Reagan and Margaret Thatcher, we lost capacity. This must be addressed.

There is lively debate from a number of economists about how to get to a more equitable economy. The request by Moneyweek editor-in-chief Merryn Somerset Webb for a sovereign wealth fund, with the government holding shares in rescued companies, is interesting, as is the idea of ​​political economist Will Hutton to expand the British Business Bank and the Future Fund. UCL professor of economics Mariana Mazzucato insists that the state must invest in innovation.

We started trying to make a different kind of society after the Second World War. We will have to do that again. Mainly, we will need to acknowledge the contributions and losses of the UK’s minorities and working class, above all. Our governments have been ashamed of creating divisions in society, particularly since austerity was imposed under the David Cameron government. Now we have an unexpected opportunity to correct the divisive consequences of Brexit.

The impact of remote work and the need to balance domestic and work life, along with warnings about mass unemployment, gives us the opportunity to draft a social contract in which we divide work more fairly. At both ends of the pay scale, people work excessively. The evidence for a more balanced relationship between work and home is compelling.

Since the crisis began, the number of artists, musicians, programmers, cultural workers, and scientists at all levels has been outstanding. The talent, the will, the desire is there to remake our world. The urgency is not in question. Globalism cannot simply be a celebration of “just in time” deliveries. It will have to be recast as a mutual, local and global mutual, so that we can learn from each other, including those who have been locked up in war zones.

Our institutions must be rebuilt with transparency, with heart and learning from the people who have cared for them, not just from managers and owners. Doctors, nurses, caregivers, and delivery people all have things to say about how their institutions might work better. The body politic and the politics of the bodies that make up our world must be reconfigured, and we must begin to think about that now.

I conclude with Freud: “The goal of psychoanalysis is to turn hysteria into ordinary human unhappiness.” That is an achievement for an individual and for a society. We cannot escape unhappiness. It is constitutive of being human, just like creativity, courage, ambition, attachment and love. Let’s embrace the complexity of what it means to be human in this moment of pain as we think and feel our way out of this, wiser, more humble and more connected.

This article is adapted from John Donne’s lecture at Hertford College, Oxford, delivered on April 24, 2020.

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