The Tribune

By Dr David F Allen and Keva Bethell

Prior to the COVID-19 pandemic, The Family: People Helping People Project - financed through a grant from the Templeton World Charity Foundation - met with over 300 participants in weekly supportive group therapy. These groups met in various locations including The Bahamas Department of Corrections, Kemp Road, East Street etc.

Unfortunately, the groups have been discontinued because of the pandemic. In spite of this, we have had virtual meetings (Zoom) to provide support for our participants and understand how the pandemic has been affecting them. Participants have expressed that without The Family group support, loneliness has become a paralysing experience. Despite being surrounded by their own family, some have said they still feel alone.

Another issue expressed was the increase in substance abuse. Participants claim they have been drinking excessively due to boredom. Connected to this, is the excessive use of alcohol combined with marijuana to achieve an even greater high. Some people have described that despite achieving this greater desired high, the side effects have been detrimental. These side effects include insomnia, hallucinations, paranoia and panic attacks.

There has also been an increase in the development of panic attacks in people who have never had them before. Panic usually starts as slight anxiety, which is a feeling of unease. This unease results from not knowing what to expect. This is true whether the person is COVID positive, has lost their job or is generally concerned about the welfare of their family. As the anxiety increases, it moves into a panic state, which, at its height, causes the IQ to decrease. This accentuates the anxiety which creates a sense of paralysis and hopelessness, making it difficult for persons to carry out their daily activities. For example, some have lost the ability to drive. Others have increased fears of the dark (particularly in relation with crime) while others fear they are unable to make ends meet. In some cases, our programme has been able to raise funds to assist in this regard.

Increased anxiety causes the increased use of normal medications, especially the sedatives like Valium, Ativan and Xanax. These sedatives increase negative feedback. As a result, they may decrease the anxiety but increase one’s sensitivity to remarks from other people. Therefore, increased sedative use can lead to verbal and physical abuse. Many times, these sedatives are used along with alcohol, which further complicates the situation and can lead to death through the inhalation of vomit. There have also been a number of suicidal attempts via overdose in this regard.

During this pandemic, some participants from our programme have died. This has created a deep grief as well as anxiety and fear among participants who have been well. We have also had participants who have suffered from COVID-19. These people have described their experience as life-threatening. They reported feeling very weak and wondered at times if death was imminent. They expressed concern about the safety of their family members, whether they would contract the virus or not.

In one case, a father became ill with COVID-19 and died. His daughter also contracted COVID-19 and died. The brother and his wife both contracted COVID-19, but thankfully, they survived. It is important to stress that in a number of COVID-19 cases, The Family Program was involved with virtual counselling. Patients claimed that this contact was invaluable and very helpful to them. We would also like to stress that during this pandemic, communication with family members and friends who may be ill is a special blessing.

During this time, people have expressed boredom, depression and anxiety associated with suicidal ideations and attempts. As stated previously, some have tried to overdose using medications. Others have tried to cut themselves or drive their vehicles into the sea. Again, when this happens, it is important to reach out, because a number of these people claimed that the support via telephone contact encouraged them to not give up.

A particular challenge is that many participants of The Family have relatives who suffered from mental illnesses prior to the pandemic. The lockdowns and other precautions taken during the pandemic produced even greater strain, leading to these people having psychotic breaks (nervous breakdowns).

Coupled with this is the difficulty of admitting patients to Sandilands, which is full. We would like to stress that the police have been extremely helpful in this regard. For example, in one case, they were willing to accompany us in the middle of the night to a very difficult situation. This enabled us to calm the patient. They escorted us to the hospital. We would also like to stress that the hospital staff, in spite of the pressure they were under, were very cordial and competent. As such, our participant was tended to promptly.

One major concern we have is that in our adolescent group therapy programme, we have had young men who were doing very well in the programme while we were meeting. Unfortunately, since the abrupt ending of the programme, some of these young men have been implicated in violent crimes, making us question whether there is more subtle gang activity taking place during the pandemic.

As paradoxical as it may sound, people who love each other claim that being together during the lockdown for an extended period, makes them have an aversion to each other and they experience a magnification of the things they detest in their partner. As a result, they experience the syndrome of the four horsemen of the apocalypse, which includes:

1. Constant criticism – ‘you never cook the meal right’, ‘you don’t speak to me nicely’

2. Contempt – name-calling ‘you are crazy like your family’

3. Increased defensiveness – difficulty listening to each other which leads to arguments, higher tension between the couple and fighting

4. Stonewalling – someone is speaking to you and you tune them out by leaving the room or taking a call. This makes the other person irate, resulting in more arguments and fights

The end result of this syndrome is that couples separate while still being together. This particularly hurts the children, producing childhood relational trauma, which has many deleterious effects in our culture.

All these things lead to increased incidences of domestic violence, whether abusive speech or physical abuse (hitting). Please note that constant belittling of another person is also abuse. An article in Psychiatric News states:

“…reports of domestic violence increased in China, France, Argentina, Cyprus, Singapore and the United States, [particularly] Portland, San Antonio, New York City and Alabama” (O’Conner, 2020).

The author went on to explain that “people who experience domestic violence are interacting with family and friends less…and many social gatherings have been cancelled”.

Unfortunately, this isolation causes some incidences of domestic violence to be fatal. The author concluded with the reminder that “everything bad is made worse during the pandemic, and domestic violence isn’t an exception” (O’Conner, 2020).

It is important that during this very difficult time, we all seek to remain calm and be willing to help by becoming our brother and sister’s keeper.