By Seth J. Gillihan, Clinical Psychologist, University of Pennsylvania

Reading daily updates about the coronavirus outbreak can feel like watching a steamroller bear down on you: It’s slow, you know it’s coming, and yet you can’t get out of the way. Every day the graphs show expanding circles of affected areas, gradually covering the world. It’s easy to feel like a helpless victim in these circumstances, as you wait to see what fate will bring you. 

And yet we’re victims only if we choose to be. We also have the option to decide how we’re going to live in the face of this uncertainty—glued to the news about the spread of the virus? Narrowly focused on our fear? Or determined to make the most of life’s gift for as long as it’s ours? 

I have to make this choice myself, of course—it’s frightening to hear about the growing number of coronavirus cases in the US and the rising death tolls. Being greeted by giant bottles of hand sanitizer in many public places underscores the sense of danger. While we always live with fundamental uncertainty about our loved ones’ health and safety (as well as our own), this viral threat certainly sharpens that reality. I’m gripped with fear at times when I imagine COVID-19 arriving in our community, potentially affecting my wife, me, and (worst of all) our kids. 

Mindfulness-centered cognitive behavioral therapy (CBT) offers us three choices in how we respond to anxiety and worry:

1. Where we direct our minds (the cognitive component)
2. What actions we choose (behavioral)
3. The quality of presence we bring to our experience (mindfulness) 

I simplify these three to Think, Act, and Be. There are countless practices in the Think Act Be framework that can lower anxiety and help us to live fully and fearlessly, even in the face of real threats. Here are some of my favorites. (For more guidance on incorporating these kinds of practices into your day, see my free e-guide, “10 Ways to Manage Stress and Anxiety Every Day.”) 

Think

1. Should You Worry? It’s hard to let go of worries about the virus, in part because our minds often tell us we need to worry about it, and that worrying is in some way useful. You might believe on some level that worrying can prevent bad things from happening, or can make them less painful if they do. Or maybe you believe that worrying shows you care.

It’s good to plan how to deal with potential problems, and to act responsibly to try to avoid them. It makes sense to wash your hands and steer clear of people who are coughing or sneezing. But if you don’t have ultimate control over the outcome, it’s pointless to worry. Things will unfold as they do, regardless of how much mental energy you throw at the situation. 

Notice today if you’re telling yourself you need to worry. Each time you realize you’re gripping on to unproductive trains of thought, give yourself permission to let go.

2. Set Your Morning Mindset: Anxiety often fills our minds with potential problems and feared failures, starting as soon as we wake up. Flip the script by deciding first thing in the morning what kind of day you’ll have. Where will you focus your attention? What quality of thoughts will you cultivate? How will you find joy? Who will you love? This is your life—reclaim your agency as author of your days.

Act

1. Let Go of Tension: Anxiety can build up in the body, creating physical tension and strain in the muscles. That physical tension then feeds back into the mind, creating further stress and anxiety. Spend a few minutes intentionally releasing unnecessary muscular tension. By first tensing the muscles, you’ll get a fuller release when you relax:

1. Sit in a quiet place and allow your eyes to close.
2. Take three calming breaths, exhaling for a count of five.
3. Squeeze your hands into fists, feeling the tension that creates.
4. Completely release the tension in your hands, feeling the tension melt away.
5. Take three more calming breaths.
6. Shrug your shoulders up toward your ears, studying the pattern of resulting tension.
7. Let your shoulders relax and drop down comfortably as the tension dissolves.
8. End with three more slow breaths, and notice how you feel now.

2. Get Moving: It’s easier for the grip of anxiety to tighten around us when we’re stationary, and especially when we’re sitting down and reading bad news. When you start to feel overwhelmed by anxiety today, do three minutes of physical movement—for example, walk up and downstairs, go for a quick walk outside, or simply stand and do gentle circles with your shoulder. Focus on the physical sensations as you move, letting body awareness anchor your attention in the present. This practice isn’t about avoiding your fear, but rather moving toward what you value.   

Be

1. Wash with Awareness: During this season of viruses, hand washing can be a fraught activity. Turn the tables today by bringing mindful presence to the experience, focusing on the sensations rather than on your fear. When you wash your hands, be aware of the full experience. Notice the sound of the faucet, the wetness and temperature of the water, the scent and slipperiness of the soap, the movements of your hands against each other, and the sensations of drying your hands. Once you’ve finished, be aware of the feeling of having just-washed hands. Pro Tip: You can do a similar practice when using hand sanitizer. 

2. Breath Minute: Focusing on the breath is one of the most reliable ways to lower anxiety and manage stress, and for good reason—it engages the vagus nerve, which activates the calming (parasympathetic) part of your nervous system.

Best of all, you don’t have to try to relax—just breathe. Your nervous system will handle the rest. Here’s what to do:

1. Set a one-minute timer.
2. Take nice calming breaths, really slowing down the exhalation, for one minute.
3. Count how many breaths you take during that minute.
4. Whatever number you count to is your Breath Number—for example, mine is seven.
5. When you feel caught up in anxiety during the day, pause and take that number of slow, calming breaths. It will take about a minute, and you won’t need a timer.
6. Notice if the mind starts to settle simply by returning to the breath

This exercise can be done anywhere—at home, at work, while driving (obviously keep your eyes open!)—whenever and as often as you need it.

None of us know exactly how things are going to go, with the coronavirus or anything else. Rather than making that uncertainty a problem, we can embrace it. The most interesting and important part of life isn’t whether things go our way, but how we respond to our challenges. As a friend once told me, “Don’t pray for an easy life. Pray for strength.” 

And finally, more than anything else, choose to abide in love. Focus your energy and attention on the people you care about, and move toward the things that are important to you. Love is the antidote to fear. 

Seth J. Gillihan, PhD is clinical psychologist; author of The CBT Deck, co-author of A Mindful Year, and host of the Think Act Be podcast. He is also clinical assistant professor of psychology in Psychiatry, University of Pennsylvania Perelman School of Medicine.