S1E29 Isolation and Quarantine

As we continue to experience this global pandemic, isolation from others remains a consistent consequence. In this episode, Dr. Pete and Dr. Rubin discuss the impact of isolation on mental health and well-being, and identify how eastern and western psychological approaches conceptualize and address this experience. Coping skills listeners may try while managing isolation and/or quarantine are presented as well.




Pete: Well, we're still in the COVID world and a lot of us are struggling, and I wanted to address what it's like for quarantine and isolation and sharing a little bit of my own personal story, but also how we've been managing it for clients and living in the world. Hey, Nikki, How's COVID over there on the on the west coast? I forgot which coast I'm on.

Nikki: I know, it was like, no, no...

Pete: No, I forgot [inaudible 0:42].

Nikki: I'm the West Coast psychologist. I'm the one in Los Angeles. Yeah, I mean, we're like in the eighth month of this now.

Pete: Or the 18th month this,

Nikki: I know, what is time? I had one of my colleagues and friends the other day said to me something like we're talking about something was a week or two ago, and she was like, "that was only two weeks ago". And she's like, "I'm sorry, two months in COVID time". And I was like, "yeah, that's right,"

Pete: It's like dog years.

Nikki: That's right, that's so accurate, that's absolutely right. Yeah I mean, something that I've been thinking a lot about is that, even as we've learned to sort of be in the world more, obviously, we're more isolated. And I kind of marvel at how it's impacting my experiences being around other people. Pete has a nickname for me, do you want to just share?

Pete: Paris,

Nikki: Yeah he calls me Paris, which references Paris Hilton. By the way, I share nothing in common with Paris Hilton, except Pete's perception that I always have a lot of social plans.

Pete: Lots of plans.

Nikki: Lots of plans, I have a lot of friends.

Pete: Well you're both cute too, she's taller than you though. She's blond, I think too.

Nikki: Yeah, but much different, we are a much different blonde. But anyway, that being said, I always have a lot of plans, and I've been finding myself in this unbelievably bizarre dichotomy where I don't really want to do anything, I don't really want to see people. And I want to see people because there's such isolation and loneliness sometimes.

Pete: I think so many people are just going to relate to that, I love that you just said it like that.

Nikki: Right.

Pete: It's a beautiful dichotomy, and dialect.

Nikki: And dialectic, but it's so odd. And I think that's something that is showing up.

Pete: Well, how is COVID these days? Like, how are you guys doing it over there in the West in California?

Nikki: Well, the cases are creeping up a little bit, they've never gotten as low as they did, like in New York, for example. Like I think right now, I think this week in LA County, I think they're like, 3 or something. So, we're very fortunate here, and that we can be outside.

Pete: You guys have the nice weather.

Nikki: Yeah, we got the nice weather.

Pete: Well, it's nice here this week, thanks global warming.

Nikki: Yeah, right. So I don't know, again, we have the benefit of being able to be outside, and that certainly helped. And I definitely would say things feel much better in that regard as post they did, obviously, early.

Pete: So feeling safe, not doing the same things that you were once able to do, obviously. And so yeah, sorry, you guys can eat outside all year round.

Nikki: That's what I'm saying, and we have a lot of nature activity as well.

Pete: Yeah, because we're about to get into the cold season on the east coast. And I think that's where we're really focused is like, 'Can we have indoor dining? What's that going to look like?' So I'm trying to help clients and the worlds that I'm in just prep for that, like, what, what can we do?

Nikki: Well, and one thing that I'm wondering about is, since this is a pretty universal experience of this sense of isolation, even as we're trying to be with other people. I'm really curious what, like the eastern traditions say about isolation, if there's anything to say, like, is there any sort of teachings around that, like, when you're alone? I mean, I don't know,

Pete: Well, we yearn for that. Well yearn is not the right verb, but like, we work towards trying to be okay with being alone. I won't be able to cite any kind of teachings on that. But I think the entire goal is to be alone. So you'll read stories of like the Buddha, who spent five years underneath the tree, and by himself in isolation, and I think this Dalai Lama will write and speak about, like, "not everyone's meant to go sit under a tree for five years". Like, it's not meant to be literal.

Nikki: Yeah. Well what about that is... because I mean, maybe what I think when I hear that is...

Pete: It's a stillness.

Nikki: Okay, because that's something that I think is interesting, because it's like,  how do we take this very difficult experience and grow from that?

Pete: Well, I think, I still feel that a lot of clients that have worked well with mindfulness within my clinical practice, they are responding more effectively and more constructively to the isolation, the quarantine, because we have skills to understand That we're always alone, that isolation is powerful, and that, 'can I just really grow from that opportunity'. And I think, one thing it's done is like, say, for example, my teacher who's older, we've been able to get him on zoom. And so now we're sitting together every day. And that's something, and people from all over, so people from Europe, from South America, and they're able to...

Nikki: Well that's interesting though, because that's not being alone, though, right?

Pete: That's right.

Nikki: There's community there.

Pete: 100%, yeah.

Nikki: Right.

Pete: So in part that's called Sangha. And so in the eastern traditions, you want to have a Sangha. Because community is part of isolation, because you're isolated with yourself.

Nikki: Yeah, that's so important to clarify. I think that's really interesting. It's like, here's another one of those dualities that are so skilfully integrated into eastern teachings. Dialectic, as you know we talk a lot about dialectics here,

Pete: Me too.

Nikki: Yeah. That isolation, so say more about the isolation?

Pete: Well, I think, as we're saying that I was thinking like, it might also help us to even see what the environment's like. So when you're zendo, another sort of five cent word within the eastern traditions. Like you're sitting in some formation where you're sitting on a cushion, and someone walks in, and you just keep sitting, so like, in the church or synagogue, or mosque or something, there's some sort of way of greeting, within a zendo it's complete silence. It's like shoes off silence, like, there's no talking. And so I think that's part of the isolation piece, because you are alone on your cushion with other people around you.

Nikki: And, what would they say the function of that is, like why strive for that?

Pete: Well, because you... and then you build strength off of the community. So when you're sitting and you're tired, you're maybe motivated by other people. So you're 100% right, that we're able to get on zoom, and so that we're not as alone, however, we're still isolated, because we are on our cushion. And that's it.

Nikki: Well, and I think that, maybe that's helpful to share with our listeners, that in that isolation with the self, in that stillness, that the reason why this is helpful, is that, and this starts to bleed a little bit into the western behavioural science stuff. Is that making that kind of space, choosing that space, and stillness, and focus is associated with all these benefit. Like, improved emotion regulation, improved psychological flexibility learning and memory, all of these.

Pete: Concentration, yeah.

Nikki: Yeah, because concentration attention. So I think that's important to say, too, because I think where people can often get stuck is like, "but why don't want to be both?"

Pete: But even as we say that, I always say, it's not tangible enough for us [inaudible-7:45] it.

Nikki: Yeah,

Pete: Like if I said, "tastes like grape lollipop", like you can grab that, but you can't grab psychological flexibility and emotional regulation.

Nikki: Right.

Pete: We see it, and we know it, but when we're trying to sell it,

Nikki: It's not... Well, this is such an annoying thing to say. So my apologies at a time, but I always say like it's concrete. And it's not concrete, because when you have practiced mindfulness, I would say for a long time, but actually not even necessarily. Like when you've practiced it, in the early stages even, when you first have that experience of like that centered, quiet, stillness, it's like, yeah, it's not like a grape lollipop. It's not quite as concrete as that and also like, you know it when you see it, you know it when you feel, that kind of thing.

Pete: Yeah, one of the stories I tell is one of my teachers, she always would say, "I just can't wait to get on the cushion". And that was a time when I was sort of starting, I was just like, "What does that mean?" Because I'm like, 'when is it beginning, when is it ending'. I was always looking at the clock inside the zendo. There's always one timekeeper, so sometimes you can see the clock, and I always look. Now I get it, because it's something that's really helpful. So what I'll share in this episode is that, so I am just ending a two week isolation after testing positive for COVID. And I'm so thankful that I'm healthy, and that I really just had some mild to moderate symptoms. So it wasn't too, too bad. So very thankful for that. And I've been working for the last eight months with people that go in quarantine or isolation. And so I think it was really helpful, we talked about empathy within psychology, and it was just really helpful to experience it. Because for example, I don't have kids, so sometimes clients will be like, "well you don't know what it's like to have kids", and I don't have to have kids to be able to work with a client who has kids, or are struggling parenting.

Nikki: Sure, sure.

Pete: I don't have to be isolated to do it. And it just gave me...

Nikki: Experiential data.

Pete: Experiential data of how I both loved and hated it. So to your point, it's like on one hand, I'm so isolated and I feel lonely on the other hand, I don't want to really be around people.

Nikki: Yeah, and I think, well again, I'm also very grateful that Pete's okay here. And I think this point about like that quarantine period, the part that was not so enjoyable to you, the hard part, I think this is where we can also bring in some of the western Psychological Science around why isolation is also problematic.

Pete: Yeah.

Nikki: Because isolation, like I can say, as psychologists, Pete and I are working with individuals that we suspect, for example, may have some kind of depressive disorder,

Pete: Right.

Nikki: Or maybe they do have a depressive disorder, isolation is something that we assess for.

Pete: That's right.

Nikki: Because the reason is that, when we feel, and this goes back to sort of evolutionary science as well, sadness, which is not depression, just be clear. Sadness, the action urge, which is the behavioural urge affiliated with that particular emotion is to withdraw, to kind of go within one, and...

Pete: Isolate, yeah.

Nikki: And we can understand that the initial probably, reason that was selected for is that there's like a place to recharge. But when it goes to extreme with depression, would be a dysregulated form of sadness, it actually contributes to maintaining those symptoms. And so when somebody is experiencing depression... and look, there's certainly a lot going on right now, that can lead to depression. Pete and I are going to assess for whether or not there is an increase in isolation, because that's going to likely worsen the symptoms. So, while there's again, it's annoying, I guess I'll say, dialectic here, duality of not wanting to be around people during this period, or noticing that, yes, sometimes there's a benefit to being by oneself. There are also some really unhelpful aspects to that. We're a social species, we actually thrive off the, I'm going to say like, the energy of other human beings.

Pete: Yeah, even like the introverts, because someone’s listening and is like, "I'm an introvert, I don't need that". It's like an introvert also need it, because we are social beings.

Nikki: Yes.

Pete: And so I think, on some level, this telecommunicating, telecommuting world gives a little bit of that. And it's just not the same. I know, like, when I'm working with students right now, we're doing clinical work, and most of its through virtual means. And so I'm encouraging them that if and when they can, to at least meet the athlete once in person, even for like 10 minutes, because it just helps. And it's just another level. I think we are going to be in a world where we're living and operating, especially in medicine virtually. So I think that's okay. But I think in this transition, if we can get that touch point, it will be helpful. And I still worked, I still taught class, I still saw some clients, I still had meetings to attend. And I was able to in isolation. I stayed,

Nikki: Right.

Pete: Like how privileged...

Nikki: And you stayed as connected as possible. And I guess to the point that you're sort of getting at is that, when we're not around other people, we're being very literal here, like, physically

Pete: Physically, yeah.

Nikki: We're not around other people. And this is not a very scientific word, though I'm assuming at some point, we'll probably be able to measure and assess this. We don't get like the vibes or like the energy of other people...

Pete: Why is that not scientific?

Nikki: Well, because meaning in terms of from a Western perspective, we're not able to measure

Pete: Oh, I guess that's [inaudible-13:20]

Nikki: Yeah,

Pete: But I talk about energy, like,

Nikki: Oh, I do too. I'm just saying..

Pete: Cause we're like hippies in a way.

Nikki: Yeah. But I mean, is like, I'm sure, I imagine that that's probably something that we'll be able to maybe clarify,

Pete: I had like a really high performing person say that recently about energy, like, "Oh, I wasn't sure about her energy". And I was just like, that's...

Nikki: Yeah, because everybody sort of intuitively knows, like people say like, "that person has bad vibes", or whatever. But the vibes of others, like we are, again, we're a social species, we evolved to be around other people we know...

Pete: Yeah.

Nikki: Like, the human species, we did not survive up until this point by just being...

Pete: Being alone

Nikki: Like a lone wolf. No, we didn't.

Pete: That's right.

Nikki: Because, the way I like to joke with people that it's not really a joke, is I'll say, "Look, 40,000 years ago", I'm like, "if you got kicked out of the, you're the human tribe". I was like, "you know what happened?" People are like, "what?", I'm like, "you died out there". I'm like, "you froze to death, you got eaten by a saber toothed tiger,"

Pete: Starved,

Nikki: You tripped and fell off a cliff". And I mean, we evolved to rely on other humans. And that's carried forward, our brains need that energy. I was assigning as homework for people once, we were beginning to be out in the world with masks. People that were sort of, I would say over isolating. I would say, "I want you to work on just going out and like, just go get a coffee,"

Pete: Yeah,

Nikki: "Like just go to the coffee shop, and even if it's just like a five minute thing, if you're not feeling comfortable, you obviously have your mask on, go in". And I can't tell you how many patients I worked with that were like, "Whoa, that made a big difference".

Pete: Yeah,

Nikki: And I said, " Yeah, because it's being around the energy of other humans that..."

Pete: Or just go for a walk or just...

Nikki: Right.

Pete: Yeah. So even when I was isolating, as much as if my energy was low, and I didn't feel like going out, I still would take the dogs out, or I still would try and like, be out and walk. I think the first week I didn't do much, but like the second week, then I started meditating yoga again. But yeah, I really didn't meditate as much. Because I always find that, I'll share this, like I struggle when I'm not feeling well to meditate.

Nikki: Make sense,

Pete: And I talked about that with my teacher a lot. Well, it's interesting, because I feel like, that's probably the best time to do it, it's one of those. It's like,

Nikki: Well, I mean, I would say that if you're not feeling well, physically, it's also like... and maybe it's not, maybe like... I mean, again, there's lots of opportunities to contact discomfort. But if you're...

Pete: Well not in that moment,

Nikki: If you have COVID, maybe that's not the moment.

Pete: Well talk about compassion there.

Nikki: Yeah,

Pete: I think we always like to give strategies. So I think what I really worked on was like self care. So like, even just binging on some movie stuff, which I love The Queen's Gambit. Have you seen that on Netflix?

Nikki: I've not, no, but I've seen that ads.

Pete: You have to watch it. It was really, really good, really well done. It was another healthy distraction, as I see that,

Nikki: Right,

Pete: Being in a happy place, being able to express yourself. So that, I think even as a mindfulness practitioner, there were nights when it wasn't feeling great, that it was like, thoughts of like, 'Am I going to get out of this?', and those are really common thoughts, and just validate that those of us that have ever been in isolation, or dealing with this quarantine, we are questioning that, and those negative thoughts are going to be there. We're curious beings, and so we're like, there really isn't a light at the end of the tunnel. Right now, I started to see in my health for the COVID isolation. But if I think about this pandemic, in general,

Nikki: Yeah, we don't know when it's going to end,

Pete: We don't know,

Nikki: We don't. Yeah, and so...

Pete: And we don't know what's after it either, which is also apart of it.

Nikki: Well, and then we go back to like, and just being put in our face here that we have never known what's going to happen. We don't know what's on their side this moment. And so when we have the urge to isolate, and again, like what Pete and I are really talking about today is, like with everything, there are times that that's helpful to do that, and there are times when that's unhelpful. It's really like checking in with yourself and seeing, like, what do you need. Like if maybe you need some stillness, maybe you need some quiet, maybe you need to go be alone for a little while, that's okay. And maybe you need to reach out and call a friend, if you're quarantining,

Pete: That's a good one too.

Nikki: If you're sick,

Pete: Stay connected,

Nikki: Stay connected digitally, like, we're thankful that we live in an era, 1918, they couldn't do that during the swine flu pandemic,

Pete: That's right.

Nikki: So we can do that. Or if you're healthy, and you can go out in a mask and just be somewhat socially distanced near other humans, that's also helpful.

Pete: That's helpful, go to the dog park, watch the dogs running. But it's funny, you mentioned the 1918, because I've said to you before, that was when my grandma was born. So I've been reflecting on that this year. And I think even in terms of compassion, because I've been thinking like, she didn't have any of the things that we have. Granted, she was a baby, she was just born, but like her parents or whatever, like I still taught class. Diagnosed on Sunday, I taught class on Tuesday, and I didn't even tell the students. So I just think it was interesting, like, that never would have happened in 1918.

Nikki: No, it never would have happened. And so there's lots of options here.

Pete: We're lots of options in 2020. So hopefully, again, I was happy to share my story about isolation and embrace my privilege within it and found some compassion and hopefully those that listen, understand that isolation, it's real, the quarantine it's scary. And just remember to practice self care and when possible celebrate the small victories.

Pete: This has been When East Meets West and Dr. Pete Economou.

Nikki: And I'm Dr. Nikki Rubin. Be present. Be brave.

Pete: This has been When East Meets West all material is based on opinion and educational training of doctors Pete Economou and Nikki Rubin.

Nikki: Content is for informational and educational purposes only.