Surviving a pandemic with P.A.U.S.E – Coping with the worry

This is an extremely worrying and anxiety provoking time for many of us. In fact, for some of us the easing of lockdown restrictions are even more anxiety provoking than when we first went into lockdown of the pandemic. After adapting and maybe even feeling a sense of safety by the “Stay At Home” message, we are now moving through phases to a new normal. This has increased uncertainty, worry and fear for many of us. 

You are not alone in your anxiety and worrying.

My name is Samantha Bennett and I am a Psychological Therapist and Life Coach who specialises in Cognitive Behavioural Therapy (CBT) and Mindfulness. In this series “Surviving a Pandemic with P.A.U.S.E” I am sharing my expertise in the hope that it may help anyone who is struggling with overwhelming emotions during this pandemic. 

This blog will introduce helpful steps to better manage our worry as we return to a new normal. 

Surviving a Pandemic using P.A.U.S.E. 

P – Pause 

A – And breathe 

U – Understand

S – Stop blaming 

E – Engage

When to use P.A.U.S.E

P.A.U.S.E is a technique you can use when you notice yourself worrying. 

Feeling anxious can be a horrible and frightening experience. Although anxiety is a natural emotion, we can become so overwhelmed that we feel out of control. Because of this, we may avoid anything that makes us anxious. Everyday tasks can become a source of stress, which may lead us to avoid them. We may neglect caring for ourselves or others.

It is understandable if you are feeling anxious about the easing of restrictions. When anxious, it is natural to worry. Many worries about this pandemic and the easing of restrictions are out of our control. We may search for answers to help us feel less anxious but find more questions unanswered.

We can help our anxiety and worry by using P.A.U.S.E. It uses simple steps to encourage us to manage our worrying instead of getting caught in spirals of worry and anxiety.

P.A.U.S.E steps explained in detail

P – Pause 

Pause any time you feel your emotions building. Pause any time you notice you are worrying.

You may feel your heart racing, breathing difficulties, sore chest, butterflies in your stomach, tingling in your arms and hands, pulsing through your body, headaches, blurred vision, ringing in your ears. You may think you are going to faint or be sick or you may feel like you need the toilet. You may feel detached from your environment or those around you. These are all natural and normal sensations of anxiety. Pause if you feel any of these sensations. 

A – And Breathe

Now that you have paused, breathe deeply for several breaths. Breathe at a slow pace that feels comfortable for you. Let your breath in and out, be even in pace. For a few moments concentrate on your body and your breathing. You might want to put your hands on your diaphragm (the upside down V area just below your ribs) and feel yourself breathing. You may want to try counting to three slowly, in your mind, as you breathe in and out, to help focus your thoughts on your breathing.  

You may have heard this advice before and have questioned why breathing? Our breath is a powerful tool to help us change the way we feel. Our bodies react to our emotions, the breath plays a big role in this. When we experience heightened emotions like anxiety, we breathe more quickly, it’s the body’s natural defence mechanism (fight or flight). We can reduce the intensity of these sensations by changing the rate of our breathing. Slowing down our breath, slows down our emotions. This makes us feel better and also gives us the best chance to manage our worry.

U – Understand

Understand that this is a very challenging time. Empathise and be kind to yourself.  It is understandable that you feel strong anxiety because of this pandemic and the easing of restrictions.

No doubt we all want to get back to some resemblance of normality, however the path is likely to trigger uncertainty and fear. Easing restrictions for many of us will reduce our sense of control and increase our sense of threat. 

Understand that worrying is part of the brain’s natural response to threat. It is trying to prepare us as we go outside more, see more people, return to the workplace, send our children back to schools and all the potential risks that are associated with these changes.

Worrying keeps us focussed on the risks so that we stay safe and aware of the dangers. However we are not looking at the whole picture when we are focussed only on threat. This creates more anxiety and more worry. We are then more likely to engage in avoidant or unhelpful coping behaviours, which reinforces our worries. Using the steps of P.A.U.S.E can help us to better manage our anxiety and introduces us to alternative ways to cope with worry.

S – Stop Blaming

Let’s stop blaming ourselves. We feel worse when we say to ourselves, “I shouldn’t be worrying”, “I’m not coping as well as others” We are less likely to react in positive ways to difficult situations when we are critical of ourselves. We are less likely to see solutions when we are harsh and uncaring towards ourselves.

You may say to yourself “stop worrying” or maybe other people tell you, “Don’t worry about it, that is not worth worrying about”. These words may be well intended but they won’t help reduce worrying. In fact, they may make it worse because we can’t just stop worrying by telling ourselves to stop worrying. 

We are designed to worry when we perceive danger. It is not our fault. Anxiety is a natural emotion and worrying is our natural response. Instead of beating ourselves up for worrying or not being able to stop worrying, understand and accept it is okay to be anxious at this time. Continue to practice P.A.U.S.E to break the cycle of worry.

E – Engage

Engage in positive actions to manage your worrying.

This may include:

Distraction and Delay. Create a list of activities you enjoy doing. When you notice yourself worrying in your spare time, choose an activity and commit to doing it fully. Tell yourself you will worry about it later, (see Worry Time below). If your worries are distracting you from what you are doing: pause, breathe, understand, tell yourself it is natural to worry, it is not your fault, it is your brain trying to find solutions. Instead write down the worry in a log book and tell yourself you will worry about it later in Worry Time then return to the task you were doing. Anytime the worry comes again go through the stages of P.A.U.S.E again reminding yourself you have written down the worry and will worry about it later in Worry Time.

Acceptance of what we can’t control. Try to accept and let go of worrying thoughts that you have no control over. Distract yourself with behaviours you have identified as helpful. Commit to the present task as fully as you can. If your worries are distracting you from the present go back through the P.A.U.S.E steps. Take a few breaths to bring your awareness to your body, letting go of your anxious thoughts. Delay your worries by telling your brain you will worry about it later in Worry Time.

Worry Time is an effective way to manage our worrying. You can use this Cognitive Behavioural Therapy technique when you notice yourself being caught up in worrying. Set time aside daily for about 20 minutes to challenge the truth and evidence behind your worrying thoughts (you may have recorded them in your log book between Worry Time sessions). Use the questions below to help work through your worries.

Here is an example of a clients’ Worry Time answers: 

  • What is worrying you? What is going on?  I’m so worried about being back to work. I am a shop manager and I’m worried I will come into contact with Covid and pass it onto my teenager who has asthma. I’m worried I am coming across as anxious to my staff and customers. I am going to be sacked.
  • What emotion are you feeling just now and how strongly out of 100%? anxious, 99%
  • What thoughts are going through your mind? (Make sure you write statements rather than questions) If I catch Covid I might become really ill, I might pass it onto my son, he might not be okay. won’t be able to cope if he gets sick and it was all my fault. I might be sacked for doing a bad job as a manager.

Now we are going to challenge the thoughts. So pretending we are in a court imagine your lawyer is making a case for the thoughts being true

  • What evidence proves these thoughts are true? (This has to be real evidence. Not based on your feelings about it) I know people who have been tested positive for Covid who didn’t know at first and went to the shops. My son has asthma. Evidence shows he is more at risk because of his asthma. My boss said finances were not good.
  • What is the likelihood these worries will happen? 10
  • If the worst was to happen how would you cope? I would be there for my son if he got sick and do whatever I could for him. I would speak to my work to tell them I needed time off to look after my son. I would ask other family members for support. I would get another job if they were to sack me and use my savings, hopefully enough, until I get one. 

Now for the opposition lawyer –

  • What evidence proves these thoughts are false? Is there any other way of looking at this? Is there anything you are ignoring in this? What would a friend say? I have been back in the shop for a month and I haven’t caught Covid, I wear a mask at work and follow Government guidelines. My son is otherwise healthy apart from his asthma and he is young. He is also being careful and following the guidance. My boss thanked me for preparing the shop for opening and I had a good appraisal before lockdown. 

Now think what the judge will say after considering both sides of the argument.

  • What is a more balanced way to think about this difficulty?  I may come into contact with Covid but I am doing what the guidelines say and protecting myself and my son from contracting the virus. I have been back at work a month and have felt well, as has my son. He is young and otherwise healthy so he may not become unwell with Covid. I feel anxious but that doesn’t mean staff and customers know how anxious I feel. My boss gave me positive feedback in preparing the shop for opening and I have increased takings in that shop for 5 years straight. The takings being down is expected due to Covid plus we have only just reopened. 
  • Can you tolerate uncertainty in other areas of your life? What advice can you give yourself to tolerate uncertainty now? I don’t know if I am going to be in a car accident but I still get in my car and drive to work. The more I go to work the more comfortable I will feel and my sense of danger will reduce. When I feel overwhelmed by my anxiety, I just need to pause and breathe and let the feelings and thoughts pass. I’m doing what I can, but I can’t control everything.
  • What emotion are you feeling now and how strongly out of 100%? Anxiety 20%

You may still feel pangs of anxiety after Worry Time but hopefully less strongly. Be kind to yourself, this is not easy to manage yourself. It takes practice to manage our worrying. You do not need to struggle with your worry and anxiety alone. Many people seek help with their worrying.

Talking with family, friends or professionals. We often hide how we are coping because of shame and fear. You are not alone in your worry and anxiety. People all over the world are experiencing more anxiety and worry during this pandemic. Sharing our experiences can be supportive and help to normalise what we are experiencing.

Recap of P.A.U.S.E. for surviving a pandemic

P – Pause 

A – And breathe

U – Understand

S – Stop blaming 

E – Engage

Closing words

I hope you find the P.A.U.S.E technique helpful to manage your worrying. Please write your comments or questions below. I would love to hear from you. Feel free to share with anyone who you think this blog might help.

For further help check out these mindful breathing exercises and blog on stress:

Free Audio and Script – Simple Breathing Exercise

Body and Breath Exercise – Another Free Audio and Script

Stress and the body

Helplines for Anxiety

Breathing Space: 0800838587 or visit MindInfoline: 0300 123 3393 or visit Samaritans U.K call 116 123.

Well wishes

Samantha Bennett MA, MSc, MAC

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