Be Careful What You Wish For
Updated: Sep 27, 2020
Written by Lauren Mawn, UNiCORN team member
“Uncertainty is an uncomfortable position. But certainty is an absurd one”
(Quote uncertainly attributed to Voltaire)
I work as a psychologist in an acute hospital in the North East of England. Recently I have been recalling a conversation I had with a colleague in early March. Covid-19 was starting to have a devastating impact in Italy, lockdown was imminent in Spain , the London spread was beginning to take hold and for our region, the first wave seemed just a few weeks away. The UK was still over a week from lockdown on the 23rd of March.
At the time of the conversation significant change was happening in our service; outpatient clinics were becoming telephone based, we were planning how to socially distance and conduct meetings, and new policies and information about how to operate were circulating. Teams were fielding a significant number of calls from patients with chronic conditions trying to assess the risk Covid-19 presented to them. Parents were contacting us to assess the risk to their children. My colleague and I reflected that we had lots of reassurance to offer but less information, facts or figures.
One part of our conversation has stuck with me;
‘It would be better if we could get the virus now, get over it, and get back to work so we can help when the big wave hits or others get ill’
We were not the only people to have discussed this idea. It is something that has been brought up by participants in our recent Uncertainty Distress Training delivered by Mark Freeston, and has been part of our research focus. The idea that if we get the virus, we then have certainty, we can be ill, recover and get on with life, relieved of the distress uncertainty creates.
On 24th of March I began to get cold like symptoms, running nose, and watery eyes. My partner was already showing symptoms and a friend had a high temperature, cough and difficulty breathing for a number of days. I felt sure that I was becoming unwell with Covid-19, and it was ‘unknown’ how unwell any of us might become. By the 27th of March I had developed a temperature, cough and chest tightness and on the 28th I was swabbed and tested positive for Covid-19.
We now had the certainty of having the virus, but the uncertainty began to spread . . . .
Is what I am experiencing normal? Is this mild? Moderate?
How unwell will I become?
Can I recover by myself? Will I need to go to hospital? Will I be transferred to ICU?
Am I going to die?
Have I infected others and caused harm?
When will my symptoms go away?
What is that smell?
Is this real or in my head?
Are others having these weird symptoms?
Why is it taking longer than two weeks?
What is the long term impact on my health?
When will I feel like me again? Will I feel like me again?
Will there be damage to my body that I cannot see or know?
Will I get it again?
Four months later and I have ongoing symptoms that include parosmia, phantosmia, anosmia, headaches and fatigue among others. My partner experiences unusual joint pain and our friend has recovered well. Now we face a whole world of well documented new uncertainties relating to the long tail of the virus which brings substantial and varied symptoms. We have years of learning ahead and while we gradually build our knowledge of the illness, there will remain many unknowns.
Will we have immunity?
Will I get it again? Will it be worse or better the next time?
Will those I love get it?
Will there be treatments?
When we get relative certainty or good news about one area more, then questions arise. In our research we consider this as ‘uncertainty spreading’. Threat (the possibility of trouble, danger or disaster) can move towards someone increasing in magnitude (e.g., Looming Cognitive Style), while we conceptualise uncertainty as moving away from a person and spreading.
As we settle into knowing that the virus and its impact will be with us for some time, we are beginning to move our research on from the impact of the virus itself (i.e., health) to the other areas of life. We will soon release a new survey exploring uncertainty distress in the areas of health, livelihood, relationships, societal and economic concern and mental health. We are excited to share this with you and learn more regarding uncertainty distress arising from the pandemic. The survey will be translated into Italian, Spanish and Greek. We hope that learning about this will enable us to help more people who experience distress both in the context of Covid-19, but also in all areas of life in which uncertainty distress arises and takes hold.
I have recently reflected again with my colleague the error of our ways and we have certainly learned a lesson; when it comes to certainty, be careful what you wish for.
*We have been using these articles as part of thought experiments in our Uncertainty Distress training to explore how uncertainty spreads even with good news
You can follow our research on our website or on Research Gate
Email us on intolerance.uncertainty@newcastle.ac.uk
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Image by Saad Chaudhry via Unsplash