York County Medicine Summer 2020 - 16

YO R K C O M E D S O C . O R G

FEATURE:

Be Smarter
Than Your Brain:
Cognitive Strategies for Physicians
During Pandemic Times
By: Allie Kochert, MA, LPC

A

s a healthcare practitioner, the COVID pandemic of
2020 has inherently affected you and your career. While
some physicians have found themselves with less work
and encountered financial strain as a result, some have been
facing the challenges physically and mentally on the front lines.
The emotional and mental stress and trauma that is affecting
healthcare practitioners is immediately clear, and without
attention can cause long term issues.

Your Brain on Stress
Increases in stress is ubiquitous during a pandemic, as the
fight-flight-freeze responses in the human brain get triggered.
The prefrontal cortex and higher-level brain structures that affect
memory consolidation and problem solving is deactivated when
the amygdala fires up, priming us for action. Helplessness, fear,
anxiety, guilt are all common reactions to pandemic stress. Our
bodies are in a heightened state of arousal, causing reduced
concentration and focus, reduced sleep quantity and quality, and
muscle tension and aches, substance abuse, and other issues.
While this stress response can be adaptive in the short term,
the long-term effects of it can wreak havoc on our system and
contribute to long-term stress reactions, anxiety and depressive
symptoms, and addiction. We have to take deliberate and
intentional steps in order for our bodies to counteract the effects
of those cascade effects. Thankfully, we can be smarter than your
brain!

Be Smarter Than Your Brain
Research has shown that interventions that initiate the
relaxation response which reduces heart rate, reduce breathing
rate, are an excellent and easily accessible options to help regulate
the amygdala and reduce the impact of stress. When we utilize
strategies such as grounding techniques, mindfulness acceptance
strategies, and mindfulness meditation, several parts of the brain
come back online-our emotion-regulatory centers, such as the
hippocampus, helps us detach away from the fight-or-flight and
once again notice the emotional response. Our prefrontal cortex,
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York County Medicine | SUMMER 2020

that essential place in our brains that helps create consciousness,
is also activated in meditation. That area of the brain is the center
of decision-making and intentional actions, and when activated,
we are in charge of our actions and aware of our behaviors.

Mindful Awareness
When we recognize how our bodies react, we are more
aware of how our brains are unconsciously running the show
and contributing to anxiety and stress. We can give thanks for
that system and have a sense of compassion for our stressed
experience. We then have the opportunity to notice, breathe,
and release. We can remind our brains that the perceived threat
can be managed. We can do this through initiating relaxation
techniques, deep diaphragmatic breathing, meditation, and
reminding our body from the ground up that it is safe, secure,
and at peace.

Some Tips to Get Started
1. Focus on what you can control. When all we hear are
things out of our own control, we feel helpless. Stick to your
typical daily work schedule and resist the urge to change it
based on fear or worry. Set boundaries at work! Reduce your
consumption of work emails at home if at all possible. Be strict
about your off time. Get that heart rate up, to initiate positive
hormonal chains to break up the stress response. Get caught up
on your favorite book or that podcast or show that everyone's
talking about.
2. Connect with friends and family online. Laugh at funny
cat videos shared with your nephew. Video chat with your
grandma, your aunt, your residency colleague. This is the time to
connect up, get yourself out of your head, and remind us we are
not alone.
3. Watch that Inner Critic. This can be tricky for high
achievers like physicians. When we have ultra-high expectations
for ourselves, we are saddled with such pressure that it can make
moving through life exhausting. Yes, we may get praise from our
bosses, but we also are full of frustration, or exhaustion, or just
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