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Mayday! Mayday! Mayday! Love and Work During the Coronavirus Pandemic

April 30, 2020

By H. Steven Moffic, MD
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

You may recall that Mayday, called out three times in a row, is what has been used as a distress call, traditionally for a ship or plane. After the call, relevant information is sent for potential rescuers.

Although we might think that it somehow is related to a day in May, Mayday was picked because it actually sounded like the French word m’aider, meaning “help me.” Even so, especially this year, it could easily be applied to May 1, otherwise known as May Day. May Day has traditionally been designated as International Workers Day. Since 2004, though less well known, it has also been designated as Global Love Day.

So, May 1 is a day that can be said to be dedicated to love and work. Freud defined mental health as “the ability to love and to work.”

However, in this current coronavirus pandemic, there have been major challenges to being able to love and work normally. Many have lost their jobs, at least temporarily. That can reduce one’s self-esteem, the crucial love of oneself. Except for inpatient services, work in our own field of mental healthcare has shifted online.

Love in these times can be enhanced and/or threatened. Being at home with loved ones can solidify and enhance love with the increased intimacy and time together. On the other hand, such closeness can illustrate that people have drifted apart. It wouldn’t be surprising to see divorce and domestic violence increase. New love is harder to be sure of without live interactions.

Moreover, at the same time, work may be occurring for one or more at home. Privacy, which can be easily compromised in this situation, is especially important if one is providing psychiatric treatment from home. Then there is the work that is always occurring for a parent or someone at home. Work really is all of our productive activities, paid or not.

These atypical challenges and overlap in love and work can necessitate a Mayday distress call. And, who better to answer that than compassionate and competent mental health caregivers?

Love has never been applied very much in mental health settings. One reason is that falling in passionate love with patients or other staff usually causes problems and is unethical.

Yet, the caring kind of love may be crucial for administrators and was the focus of the lecture I gave when I received the 2016 Administrative Psychiatry Award from the American Psychiatric Association. Enough caring love of staff, along with realistic expectations, is a key for reducing our epidemic rate of burnout. Given the increased stress of the change of how we deliver services, positive alliances of administrators with staff, of staff with each other, and for staff with patients, was never more important.

Whether this can be generalized to other relationships is unclear, but in marriages, research indicates that the “magic ratio” of at least five positive interactions is needed for every negative one in order to resolve problems well enough. Here are five examples of positive ones:

  • Be interested in the other and periodically ask how he/she is doing;
  • Demonstrate that they matter;
  • Provide intentional displays of appreciation;
  • Find opportunities for agreement; and
  • Empathize and apologize

The worst negative interaction is anything that comes across as contemptuous.

However, a loving caution is also necessary. Too much caring for others can lead to compassion fatigue and neglecting one’s own well-being, as has been reported in the recent suicide of Lorna M. Breen, MD, a New York emergency physician. To complicate matters further, if the caregiver has been infected with the coronavirus, as Dr. Breen was, we now are considering that it may be possible that the effects of the virus may include brain insults, which then in turn can compromise coping skills. We see something like that in combat soldiers who have sustained traumatic brain injuries along with PTSD.

At home, we require more work at love. It is an unnatural situation for most of us to be staying at home alone or with loved ones or, conversely, in the opposite situation of being on the front lines of this new risk outside of the home and having to also protect family. Maybe all of this is a test of love. Harry Redner in his book “Ethical Life” says that “morality is the ethic of love.”

Therefore, what should be called out for on this particular May Day is:

Love your work, and work on your love!

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