Coping with Uncertainty During
COVID-19: An International Gottman Trainer Shares Their Perspective

Michael McNulty, Ph.D., LCSW,
Contributor

Apr 9, 2020

Ambiguity related to the ongoing
virus pandemic leads to complicated feelings and overwhelm.

Uncertainty is the biggest
psychological challenge individuals, couples, and families face during the
COVID-19 crisis. There are so many critical unanswered questions about the
impact of COVID-19, including:

• How will those infected be
  treated? Will they receive treatment? Will they survive?
• Will I or any of my loved ones
  catch the virus? If so, will I or they survive?
• How will the spread of the virus be
  contained? How long will it take?
• How long will restrictions last?
• What will be the impact on the
  economy?
• What will be the short-term and
  long-term impact on life as we know it?

Unanswered questions like these
make facing the crisis so overwhelming. In more straightforward disasters, over
time, people begin to grieve “who” and “what” they have lost and to move
forward with life. The uncertainty and ambiguity related to the ongoing
COVID-19 virus make grieving much more complicated. Overwhelmed by stress,
people alternate between feeling extremely overwhelmed or acting as if nothing
has changed, which leaves them coping poorly or unable to cope.

In this post, I will explain a
theory called “Ambiguous Loss,” developed by Dr. Pauline Boss, which helps us understand
and cope with uncertainty. I will then adapt Dr. Boss’ recommendations to help
individuals, couples, and families face the COVID-19 crisis. I will also
provide tools from Drs. John and Julie Gottman and others to help people put
Dr. Boss’ recommendations into action to help people cope and live well in
these uncertain times.

Ambiguous Loss

Dr. Pauline Boss of the
University of Minnesota has developed a theory called “Ambiguous Loss,” which
provides guidelines for facing uncertainty. I learned her theory and techniques
before I went to Sri Lanka to provide support after the 2004 Boxing Day
Tsunami. I taught them to grateful counselors there at the time and on many of
my 22 subsequent visits. I want to share them here as a resource to help people
cope with the COVID-19 crisis.

According to Dr. Boss, one type
of ambiguous loss can be a loss or losses, which are more complicated because
they involve unimaginable circumstances that result in ambiguity or
uncertainty. Grief becomes frozen. People do not know what they are grieving,
and how to begin to move forward with life. For example, after the World Trade
Center Disaster and The Boxing Day Tsunami, survivors lost family members
suddenly in horrific ways beyond imagination. They were uncertain about whether
their loved ones had died, if and how to grieve, and how to move forward. With
no templates to guide them, they struggled with how to cope. They alternated
between acting as if the disaster had not happened and re-experiencing the
trauma as if it were happening repeatedly. Dr. Boss refers to this cycle as
chronic re-traumatization. Dr. Boss’ theory is used to help people in these
kinds of disasters cope and live well with uncertainty.

The COVID-19 crisis poses similar
challenges. As survivors, we remain physically present in our homes and
communities as the crisis continues to unfold. We and our friends and loved
ones face the threat of becoming infected and even dying. Life as we knew it
has and will dramatically change. So much remains to be seen. We are left,
psychologically, to make sense of these changes and losses and how they will
affect our lives.

The following recommendations are
based on Dr. Boss’ guidelines. I have adapted them to help people face the
COVID-19 crisis.

1. Label the Losses as Uncertain
or Ambiguous

When thinking about or discussing
the crisis with family and friends, label the changes and losses as “uncertain”
or “ambiguous.” Remember that feeling confused, hopeless, disoriented,
discombobulated, or overwhelmed is normal. Acknowledge that crises of this
nature are the most difficult to face because so much is uncertain.

Labeling the changes and losses
as “ambiguous” or “uncertain” helps people understand why facing the COVID-19
crisis is so challenging:

• People are living in a horrific
  context that is beyond their human experience.
• Life has changed dramatically and
  continues to do so on a day-to-day basis in ways that are uncertain, and
  involve the threat of infection, loss of life, and financial survival.
• The ultimate impact on the
  economy is unknown.
• There are no straight-forward
  answers to the ever-changing complex problems people face that result from this
  crisis.
• Achieving a true sense of mastery
  over problems associated with the COVID-19 crisis is unrealistic.

When people make these
realizations, it helps them to:

• Increase their abilities to face
  the crisis in the moment one day at a time.
• Temper their need for mastery.
• Be more open, flexible, and
  gentle with themselves.

2. Normalize Ambivalence

Most people feel ambivalent about
having to face a major crisis like COVID-19. That’s normal. When people face a
crisis that involves uncertainty, the crisis becomes more real. When they avoid
facing a crisis, they can pretend it’s not happening. When their ambivalence is
understood and even shared, people tend to feel better able to begin to accept
their tenuous new normal, share perspectives, and engage in healthy dialogues.

3. Share Perspectives

In an uncertain or ambiguous
context, people will have different interpretations of new information about
the virus, its impact, and how to manage key issues. That’s to be expected.

In the COVID-19 crisis, examples
of everyday new information from the media include:

• How to protect one’s self from
  the virus.
• How to limit the spread of the
  virus.
• Current statistics on the virus.
• The impact on the economy.
• The anticipated length of the
  crisis.
• The anticipated length of
  restrictions.

In the COVID-19 crisis, examples
of key issues include:

• Whether to leave home for work.
• Whether to leave home for other
  reasons, such as exercise, socialization, caring for more vulnerable family
  members, etc.
• How to manage related financial
  concerns or crises.
• How to meet basic needs for food,
  medical needs, etc.
• How to connect with family and
  friends.

Friends, family members, and
partners do better when they agree to hear and respect one another’s points of
view in these uncertain times. In doing so, they create safe places in their
relationships, families, and support systems for people to open about their
perspectives, which include their concerns, feelings, and needs.

Failure to share leaves people
alone with their stress, which can increase feelings of anxiety, panic, and
depression. Sharing perspectives in a supportive atmosphere helps people
process their experiences and feel securely connected to friends and loved
ones. This promotes resilience for all involved.

Discussions about key issues
involving diverse perspectives, such as social distancing, managing finances,
and others, can become impassioned. Dr. Boss suggests while having discussions,
people should be ready to repeat this phrase: “It’s ok if we do not all see it
the same way now.” This helps people with different points of view connect with
and support one another even with their differences. Here are some resources
that help people share and empathize with each other’s perspectives, and make
time-sensitive decisions:

• Drs. John and Julie Gottman have
  developed the following tools that help people share and listen to one another’s
  perspectives:
• The Gottman-Rapoport Exercise
  helps people with diverse points of view dialogue and empathize with one
  another.
• The Stress-Reducing Conversation
  Exercise helps people how to listen and empathize with one another about
  stress.
• The “Great Listening” card deck
  (in the free Gottman Card Decks App) helps people to improve their listening
  skills.
• Emotion Coaching techniques help
  parents listen to their children’s feelings.
• For partners or family members
  who are facing time-sensitive issues that require action and a decision, the
  Gottman Compromise Ovals exercise can help them to do so.

In addition, the Feeling Wheel
helps people who are not used to identifying and talking about their feelings
do so.

4. Be Flexible and Creative

When people challenge themselves
to empathize with each other’s perspectives, they become more flexible and open
in their thinking which helps them to cope. The COVID-19 crisis is
ever-changing. Flexible and creative thinking prepares people to respond to new
information and shifting challenges.

5. Reconstruct Routines and
Rituals

Currently, the COVID-19 crisis
has shifted everyone except those in the essential workforce to their homes,
and away from work and school. In times of crisis and displacement, family
members, partners, and friends function better when they conscientiously
reconstruct routines and rituals in their new context, rather than forego
them. 

Routines and roles bring
structure to our lives. They help people know what to expect each day, and who
will do what. This helps children and adults to function, and cope. Families,
partners, and roommates should develop schedules and assignments that take into
work and home-schooling obligations, spatial needs, computer access, and
support. Routines should include the roles people will play to help the
household function, and the tasks they will perform.

Rituals help people connect on a
regular basis and live life in fun or meaningful ways. They can be a break or a
distraction from the day to day stresses of facing the COVID-19 crisis. People
living in the same household should create new rituals for this time when they
will be staying home. These can include rituals that involve:

• Family or House Meetings to Talk
  About Coping and Stress
• Family and Group Meals
• Breaks from Work and School
• Leisure Activities
• Games
• Movies
• Walks

How they are designed is up to
all involved. Hopefully, everyone has input.

People can create rituals that
bring a lot of fun to their lives. For example, one of my high school friends
has started a game night at his house with his family members. They dress the
part of characters in board games like “Monopoly.” They take pictures of one
another in their outfits and post them on Facebook. Whoever wins gets to choose
the game for next night.

People can also create rituals to
connect with the outside world through teleconferencing programs like Zoom,
Skype, and others. This enables children to see their friends and classmates.
Adults can have time with their friends. They can have dinner parties or happy
hours or coffee online. All involved can find ways to play games with friends
or other families online. People can attempt to connect with friends and family
members who they have not had time to connect with prior to the crisis.

Several communities have
developed wonderful rituals to help children begin the school day at home, to
express gratitude to health care workers, and to honor birthdays or homecomings
from the hospital. These rituals are great examples of how to celebrate and
live life in a meaningful way during a pandemic while respecting the importance
of social distance.

It is important to note that
routines and rituals will most likely be modified as restrictions shift in the
future, as the need for social distancing changes.

Here are some resources to help
couples, families, and friends create rituals:

• Dr. Bill Doherty’s book, The
  Intentional Family
• Drs. John and Julie Gottman’s
  exercise “Build Rituals of Connection” is available in a card deck (for
  couples) in the Gottman Card Decks App. The suggestions are mostly for couples,
  but the deck includes basic instructions for building rituals that friends and
  families may use

While neither of these resources
have specific ideas for rituals in a time of social distancing, they do explain
how couples and families can build rituals.

6. Find Meaning

Finding meaning in times of
crisis can help people persevere. Making sense of the existential reasons why a
disaster occurs often helps people to cope. Some people will look to their
religious or existential beliefs to determine the reasons why this disaster is
happening. As we anticipate 100,000-200,00 deaths in the USA, others will feel
that the fact the pandemic is occurring is senseless. Dr. Boss reminds us when
even we determine that a disaster is senseless or has no meaning, that that is
meaningful.

In his book, Man’s Search for
Meaning, Viktor Frankl, the late neurologist and psychiatrist, who was a
concentration camp survivor reminded us that people who find meaning in their
day-to-day lives are the ones who survive disparate circumstances. Frankl once
said, “The meaning of life is to give life meaning.” In times of crisis, there
are so many ways to take actions that give people a sense of meaning or
purpose.  Here are some examples:

• At the risk of losing profits, a
  business owner chooses to close their business to avoid the spread of the
  virus.
• An individual may find ways to
  make sure a lonely neighbor has companionship (via the internet).
• Healthcare workers risk their
  lives in less than optimal conditions to treat the sick and the dying.

People who serve or care for
others remind themselves and others that we are all part of a human experience.
They relate to suffering and care for fellow human beings. Their intentions and
actions give all members of society hope as they struggle to cope and survive.

People can find meaning in how
they use their extra time at home. For example:

• A family who is spending more
  time together may use the crisis as an opportunity to bond or work on their
  relationships.
• A couple uses their additional
  time together to actively work on their relationship.
• Friends who have not seen each
  other in years may find time to reconnect by video or Skype.
• Individuals use extra time to
  re-examine their priorities and goals.
• Those who lose careers may work
  to discover opportunities for new career paths.

People can choose to use their
time sheltering at home or in lock-down to accomplish important goals. In any
disaster, people still have choices to live life in meaningful ways. Their
intentions and actions often define them moving forward. Making sense of a
disaster and having a strong sense that one’s life remains meaningful helps
people persevere in their attempts to cope, survive, and rebuild.

Michael McNulty, Ph.D. is the founder of the
Chicago Relationship Center and a Master Trainer for The Gottman Institute. He
has over twenty-five years of experience in counseling and psychotherapy