Re-Entry Anxiety & Covid-19

Lara McCallum Minasyan

I answered my phone mid-morning to the sound of Sarah choking back tears. She struggled to utter discernible words and I feared news of a tragedy. Instead, she described what so many parents have experienced as children return to school. At morning drop-off her son, Ian, had clung to her in tears. His heart pounded as he described a stomachache and deep yearning to return home with mom. Heeding the principal’s advice, Sarah encouraged Ian and left him in the school’s care despite his pleading. What was wrong? He had never had difficulty going to school pre-pandemic and seemed to have enjoyed the first few days this year. Did she do the right thing by leaving?

Sarah and Ian’s plight is mirrored in families worldwide as children and adults re-enter schools, workplaces, and other social activities 18-months after the Covid-19 pandemic first brought life as we knew it to a halt. Many are eager to return to a pre-pandemic lifestyle, but reentry after months of isolating from social interactions can be daunting. As MIT Psychologist Maryam Khodadoust explains, “Reentry anxiety is not, in itself, a mental health disorder. It’s a natural reaction to a traumatic event- the pandemic. After we’ve spent more than a year impressing on our children how dangerous the world outside is, it’s only natural for some of them to be hesitant about stepping right back out.”

Just as pandemic trauma impacted individuals’ functioning to varying degrees, so will the stressors associated with reentry. This stress is confounded by the lingering uncertainty of the pandemic situation and significant life changes resulting from it. Some will seamlessly adjust to their “new normal,” while others will grapple with debilitating anxiety.

As schools reopen and gyms continue shifting toward pre-pandemic operations, gym owners will witness gymnasts and staff members who, like Ian, struggle with reentry anxiety. Symptoms may appear upon reentry to the gym; a coach returning to in-person coaching or recreational gymnast joining classes. Symptoms may also pop up in the gym as individuals, who thrived in the gym for months post-lockdown, navigate reentry into other settings. For example, the gymnast who has never displayed fear suddenly balking on beam series the week she returns to in-person school. How can we help individuals cope with reentry anxiety en-route to healthy outcomes for all?

• Listen, Empathize, Validate & Normalize: Feeling heard, understood, and validated are paramount to healing. Rather than doing the talking, engage in active listening and work to convey empathy. Though individual situations differ, we have experienced a collective trauma. Reassure the individual that what they are feeling is a normal reaction and they are not alone. Validate their feelings and provide an empathic environment to facilitate healing.
• Provide Relationship Building Opportunities: The pandemic has left many feeling isolated and has eroded some of the interpersonal relationships that were previously fostered by daily social interactions. Richa Batia, MD, of the Anxiety & Depression Association of America reminds us that “social connectedness is a positive, protective factor for mental health.” Encourage connectedness by providing social opportunities for staff members, gymnasts, and gym families outside of regular gym activities. Begin with activities that most individuals will be comfortable with, like an outdoor movie night or day hike. Take time to connect individually with staff, gymnasts, and gym families on a regular basis to rebuild business relationships
• Encourage Mindfulness Practices: Each individual has a zone of optimal arousal in which they experience heightened functioning and relative comfort. Dr. Daniel J. Siegel termed this the “window of tolerance.” When facing anxiety provoking stimuli the sympathetic nervous system activates a fight-or-flight response, which elevates one’s arousal beyond his or her window of tolerance. In a state of hyperarousal, humans lose much of their ability to cope on a cognitive level and may experience physical and emotional discomfort.Mindfulness approaches provide quieting tools that help one to bring their arousal back within their window of tolerance, providing short-term relief and the mental space necessary to observe, comprehend, work through, or accept the source of discomfort. Mindful breathing practices can be implemented into daily training for gymnasts and staff, with benefits extending beyond relief from reentry related anxiety. Individuals may also benefit from mindfulness apps such as Calm and Headspace, which both have kid-friendly editions.
• Support Gradual Reentry: Avoiding a feared stimulus promotes further anxiety, so it’s important to begin reentry as soon as appropriate. However, full immersion into a pre-pandemic lifestyle may be contraindicative. Gradual exposure is an empirically supported approach to anxiety treatment.When a gymnast exhibits fear of a skill, we go back to the basics and help him or her to build feelings of safety and self-efficacy at each stage in the learning process. Overtime, through repeated exposures to increasingly challenging drills/skills, the body learns that it is safe and symptoms such as sweaty palms, racing heart, and balking dissipate. Small steps toward reentry are similarly supported. A coach who feels unease can begin by leading conditioning exercises where they feel safe, perhaps outdoors with physical distancing. A gymnast experiencing anxiety may first observe class and then participate for increasingly longer stretches of time, working on the periphery before engaging in spotted or group exercises. Be prepared to support gradual reentry approaches for staff members and gymnasts.
• Be Patient: David Siegler, MD, FAPA, stated “Lockdowns and social isolation may have been necessary, but they are not something that our brains are used to, nor can we easily flip a switch back to normal.” There will be an adjustment period and individuals will adjust at varying rates. Just as gymnasts regained prior skill level at varying rates post-lockdown, there is no set timeline for reentry.We must also be mindful that “return to the world as we knew it” means adjusting to a whole new world for young children who do not recall a life without face masks, physical distancing, and unseen dangers lurking in social settings. Behaviors that were previously expected of preschool and kindergarten-aged children entering gymnastics classes (ex. following a leader, waiting in line) may not have been learned during remote learning. Coaches should be prepared for these unique challenges.
• Recognize Red Flags: UCI Health child psychiatrist Dr. Leslie B. Tarver warns to look for red flags such as “children becoming more withdrawn or showing new behaviors- such as panic attacks, weight loss or gain, abdominal pain or headaches,” signs of stress that should be discussed with a doctor and may warrant the care of a mental health professional. Adults with these symptoms should also consult with a professional.

In considering the aforementioned tips, gymnastics professionals must always be mindful of what approaches are appropriate for their relationship with an individual. If a child is exhibiting signs of impaired functioning, maintain open communication with parents and do not attempt to step into the role of a mental health professional. By providing a climate of acceptance and support, gymnastics clubs can be a safe place for children and adults to rebuild social interaction skills and adjust to current and post-pandemic life.

Works Cited

Schive, Kim. “Helping Kids Cope with Reentry Anxiety.” MIT Medical, 1 July 2021, medical.mit.edu/covid-19-updates/2021/07/helping-kids-cope-reentry-anxiety.

Seigler, David, MD. “Reentry Anxiety.” Psychiatric Times, 27 July 2021, www.psychiatrictimes.com/view/reentry-anxiety.

“10 Tips to Manage Re-Entry Anxiety Related to the Covid-19 Pandemic.” Anxiety and Depression Association of America, ADAA, 24 July 2020, adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/10-tips-manage-re-entry-anxiety-related-covid-19.

UCI Health. “Coping with Reentry Anxiety as the Pandemic Wanes.” UCI Health | Orange County, CA, 15 June 2021, www.ucihealth.org/blog/2021/06/reentry-anxiety.