The spread of the SARSCov2 virus has introduced widespread threat, economic destabilization, and social isolation.
There continues to be deep disruptions to our daily life. One early response to the pandemic challenged us to constrain our essential need for human connection. For many, real threats to physical safety and the reactions to the mandates for social distancing and stay-at-home orders continue to present challenges to self-regulation and anxiety management. The Polyvagal Theory and the Oxytocin Hypothesis provide scientific underpinnings for the individual neurophysiological response to threat and the potential impact of the COVID-19 pandemic on adaptation to the crisis.
Polyvagal Theory (Stephen Porges) proposes that the autonomic nervous system plays an important role in exacerbating or dampening threat reactions through portals of social engagement. This system evolved to downregulate the defense response and to promote calmness and connectedness (i.e. ventral vagal state). This type of nervous system response promotes integration or “tuning” of regulatory systems and functions as a social engagement system that helps the human navigate relationships.
Oxytocin Hypothesis (C. Sue Carter) identified that oxytocin pathways (oxytocin, vasopressin, and their receptors) are at the center of physiological systems that permitted the evolution of the human nervous system and allowed the expression of modern human sociality and child-rearing. Oxytocin creates an emotional sense of safety, dynamically moderates the autonomic nervous system, and influences vagal pathways. Oxytocin pathways also have antioxidant and anti-inflammatory effects on the body. Autonomic regulation depends on oxytocin pathways in the establishment of social bonds and in the regulation of the stress response. These pathways act as “neuromodulators” along with polyvagal mechanisms to downregulate defenses and promote calmness and connectedness. Both the Polyvagal theory and the Oxytocin Hypothesis function to regulate the social engagement system in the individual; a mixture of activation and calming.
According to Stephen Porges, the initial effort to control the spread of the SARSCov2 virus through social distancing and stay-at-home orders produced a paradoxical challenge to our essential need for human connection and social support in response to threat. The body is biologically tuned to detect safety and danger and to dampen reactions to threat through social engagement. The instinctive need to co-regulate and calm self with safe proximal relationships is inhibited by the need to socially distance to prevent the spread of the virus. The methods to mitigate the spread of the virus requires us to not comply with our automatic programming to move toward others in reaction to threat.
Efforts to mitigate the spread of the virus through social distancing are disproportionally affecting the population in different ways. There is wide range of variability in the reaction to the pandemic threat and the loss of social support. People have different abilities to self-regulate. Bowen theory describes how the interaction between the level of differentiation of self and the level of chronic anxiety accounts for the variability in responses to the current challenges.
In response to the early shut-down in California due to COVID-19 in March, I began providing psychotherapy services via telehealth from my home.
From my anecdotal observations in early lock-down, clients reported feeling emotionally closer to their spouse/partner and to their children. Despite the fear of contracting the virus, worries about furloughs and job loss, financial instability, the impact of school closures, and concerns about the safety of their extended family and friends, they also reported enjoying the “pause” from everyday work, school and other social obligations. There seemed to be adequate energy and engagement to tackle the stay-at-home daily challenges and the logistics of working from home. In the early stages of lock-down, the polyvagal and oxytocin neuromodulators were activating an automatic move toward family members at home (togetherness process) and appeared to be facilitating calmness and relatively effective adaptations to the threat.
Now, thirteen weeks into the lock-down, clients who are still at home are beginning to report increased tension between partners, increased acting out in the children, increased financial stressors, and more uncertainty about the possible “surge” from the virus as the country is in different stages of re-opening. The shift from a comfortable, calm togetherness is moving toward increased sensitivity and tension in the family. There is the emergence of family emotional system patterns of distance, conflict, symptoms in a spouse, and increased child-focus, with a marked worry valence about the disruption in the educational and social development of their children.
Initially, the automatic regulatory system to downregulate defenses and promote a mixture of activation and calming resulted in a decrease in stress reactivity and an increase of self-regulation in individuals. The autonomic programming to calm self with family engagement was initially effective but is now becoming less effective. The family emotional process is increasingly challenged by the togetherness force and tension is increasing in the family system. The resources of human contact that were initially calming are now manifesting as threat.
Bowen theory predicts that as anxiety increases in the family emotional system, there will be predictable moves to recalibrate the togetherness/ distance balance between family members. This need for physical and emotional “wiggle room” in the family members appears to be increasing. This process is activating anxiety-binding patterns leading to symptoms that vary in intensity on a continuum. Families on the lower end of the differentiation continuum are manifesting more intense symptoms and families on the higher end are manifesting less intense symptoms.
The Polyvagal Theory and Oxytocin Hypothesis provide models to explain how the mandates for social distance in response to COVID-19 is disrupting the human biological imperative to connect through social engagement. Bowen theory expands the understanding and predictability of individuals functioning under the pandemic threat to the broader family emotional field. Anxiety-binding patterns manifest in relationship systems, not just in the internal neurophysiological workings of the individual. The individual is regulated by family interactions and family interactions are regulated by the individual. Bowen theory offers a “systems” view leading to a broader understanding and predictability about how humans behave in reciprocal reaction to one another during periods of stress. Polyvagal theory, Oxytocin Hypothesis, and Bowen Family Systems Theory all contribute to an understanding of the underlying response mechanisms that determine thresholds of reactivity at the individual, family and societal level.
At this stage of the pandemic, all states in the US are dealing with “opening-up” society. Some of these protocols seem to be grounded in science and public health recommendations and others appear to be less thoughtful and anxiously driven. The scientific/public health community is waiting for the predicted increase in viral infections and the spread in hot spots around the country as states try to return to normal. While the world is waiting for a vaccine, society continues to be tasked with the paradoxical demand to both avoid the virus and to socially engage.
One outcome of the current crisis is that the COVID-19 pandemic is occurring during a time when much of the world has tools that enable us to connect even when we need to isolate. Modern technologies using virtual platforms and other communication tools are now providing many with opportunities to have virtual contact with others while staying physically apart. The utilization of virtual technological in the response to the COVID-19 crisis is impacting all segments of society. This current adaptation to the pandemic may significantly influence long-lasting changes in the future.
517. Sue Carter (2017). The Role of Oxytocin and Vasopressin in Attachment. Psychodynamic Psychiatry: Vol. 45, Special Issue: Neurobiology of Attachment. pp. 499-517.
Kerr, Michael E. (2019). Bowen Theory’s Secrets: Revealing the Hidden Life of Families. New York: WW Norton.
Porges, S.W. (2020). The COVID-19 Pandemic is a paradoxical challenge to our nervous system: a Polyvagel Perspective. Clinical Neuropsychiatry, 17(2), 135-138.