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All signs point to what should be a summer of reuniting with loved ones, reentering society, and to some degree, returning to normalcy for Connecticut residents. But in a series of interviews, therapists told CT Examiner that many of their clients with clinical anxiety may not be ready to go back out into the world just yet.
“My clients with anxiety are freaking out right now,” said Chantel Herron Elliott, a licensed clinical social worker in Danbury. “I would love to say that they’re happy to go out into the world, but for a lot of them, no. I’ll be working with clients for months or years to get them to return to society.”
According to a survey from the American Psychological Association from March, almost half of Americans report feeling comfortable returning to pre-pandemic life. And vaccinated Americans are just as likely to say this compared to those who have not received the vaccine, even though the Centers for Disease Control and Prevention finds that the Pfizer and Moderna vaccines are about 90 percent effective against infection, and the Johnson & Johnson shot is 66 percent effective, with all vaccines nearly completely effective at preventing hospitalization and death.
“My clients with anxiety are freaking out right now,” said Chantel Herron Elliott, a licensed clinical social worker in Danbury. “I would love to say that they’re happy to go out into the world, but for a lot of them, no. I’ll be working with clients for months or years to get them to return to society.”
The CDC has also reported just 5,800 “breakthrough” cases of fully-vaccinated people with the virus out of the 77 million vaccinated Americans. Still, many Americans with anxiety, once vaccinated, struggle to recalibrate from a once reasonable fear of catching COVID-19.
“Humans tend to be very bad at judging risk,” said Jill Whitney, a licensed marriage and family therapist in Old Lyme. “Folks who tend toward anxiety magnify risks in their mind, and tend to give more weight than a risk management scientist might to the likelihood of some bad thing happening.”
That magnification continues even as actual risk decreases, said Jill Millea, a counselor in Bozrah.
“We know the risks have gone down significantly, but there is still some risk, with variants out there and no herd immunity yet,” Millea said. “Even if the actual level of risk is going down, anxiety will always make it seem much bigger than it is.”
Nowhere was that risk magnification clearer than in the aftermath of the CDC’s decision to pause administration of the Johnson & Johnson vaccine earlier this month, therapists said, sharing that many of their clients felt that their anxiety about vaccine safety was validated by the news.
“Humans tend to be very bad at judging risk,” said Jill Whitney, a licensed marriage and family therapist in Old Lyme. “Folks who tend toward anxiety magnify risks in their mind, and tend to give more weight than a risk management scientist might to the likelihood of some bad thing happening.”
“One of my clients got the Johnson & Johnson vaccine before the pause, and then when she heard about everything, she had panic attacks,” said Julia Israelski, a licensed clinical social worker in Essex. “She became really preoccupied with every sensation she had because she was sure she was going to have a blood clot.”
About half of Elliott’s clients have chosen to get vaccinated, and many of her clients with anxiety have been influenced by misinformation about the vaccines, she said.
“Anxiety is rooted in the fear of the unknown, and during COVID, people with anxiety are looking for answers that we don’t necessarily have,” Elliott said. “They’re looking for answers, and a lot of the time, they find answers that turn out to be conspiracy theories.”
Responding to clients sharing false information in therapy is tricky, she said, because she never wants to push back too much and start an argument. Still, for clients who are too anxious about the vaccine to get it, anxiety about potentially contracting COVID-19 can be heightened even more, she said, because they are not protected.
Whitney said she’s also struggled with clients sharing conspiracy theories in sessions, because she has to set aside her personal viewpoints on vaccine safety to help her clients think through their decisions, even if the end result is one she personally disagrees with.
It’s been a challenge across the board throughout the pandemic because being anxious about a pandemic that has killed millions is an entirely reasonable emotional reaction to a crisis, she said, describing the situation as “objective uncertainty about a very serious risk overlaid with individual anxiety.”
Elliott echoed that frustration, noting that it’s “very difficult” when the reason for a client’s anxiety has some basis in reality.
“Who’s to say what’s a reasonable fear response as opposed to a disordered anxiety response?” Israelski said. “As the pandemic has unfolded, guidance about what is and isn’t safe has been changing constantly. It’s a tricky thing to advise or challenge because we haven’t always had enough hard information.”
“Start with having one family over to your house to eat dinner outside,” Whitney said. “Then, maybe you’ll be ready to go to a restaurant outside, and then maybe dinner with another family inside. You just have to be patient with yourself.”
Israelski said that she’s heard from many of her patients with social anxiety that during the pandemic, being able to avoid triggers brought a sense of relief, but now, the idea of reentering society is “paralyzing.”
“Avoidance perpetuates anxiety, and hiding from the things that give a client anxiety allows them to ignore deeper issues at play rather than working on them,” Israelski said.
Avoiding socialization is also not without costs, Whitney said, noting that human interaction is profoundly vital to mental and physical health.
“These clients would benefit a lot from socializing, but they’ve convinced themselves not to do it,” Elliott said. “I mention that the research says there are safe ways to socialize, but if they choose to stay inside, that’s up to them.”
For clients who do choose to try to begin interacting with the outside world again, or who are required to for work, Whitney recommends baby steps.
“Start with having one family over to your house to eat dinner outside,” Whitney said. “Then, maybe you’ll be ready to go to a restaurant outside, and then maybe dinner with another family inside. You just have to be patient with yourself.”