A thought experiment for Alphas

Monika Tempel, Scientific Advisor, Alpha1 Germany eV.

No one knows exactly how long it has existed. But one thing is certain: it will be with us from now on. How can Alphas cope with the SARS-CoV-2 virus?

Understandable fears

The Alpha1 Foundation website contains, among other things, the following statements regarding „Alpha-1 and COVID-19“ (translated from English by Monika Tempel): „Are A1 patients at higher risk of contracting COVID-19? There is no evidence on which a definitive answer could be based, but the expert opinion of our medical and scientific leadership at the Alpha-1 Foundation is that with Alpha-1 antitrypsin deficiency (Alpha-1), and especially with Alpha-1 combined with lung or liver disease, you are placed in an increased risk category…”

Do MZ-type carriers have an increased risk of severe COVID-19? We currently have no way of estimating the risk for carriers of individual abnormal Alpha-1 genes…
Do MZ-type individuals with a diagnosed lung disease have an increased risk of severe illness from COVID-19? All individuals with an underlying lung disease, whether MZ or MM (normal), have an increased risk of severe illness if they contract COVID-19…“

No wonder that, given these vague formulations and general recommendations, anxieties in Alphas are more likely to be fueled than soothed. Increased risk – more severe illness… these are hardly terms that signal "all clear" to the brain. Added to this specific warning of danger for Alpha-1 patients are the anxieties that Alphas share with everyone else:

• Stresses caused by quarantine measures (being locked up, boredom, lack of structure)
• Existential fears due to financial losses
• Fear of infecting oneself or others (despite all protective measures).
• Fear of losing loved ones to COVID-19

These fears are understandable. It is important to acknowledge them and not hastily dismiss them with the slogan "crisis as an opportunity".
Precautionary measures and changes in behavior must be carefully considered, constantly reviewed, and adapted to the specific situation. This applies to every individual and to society as a whole.

When used and addressed correctly, fears can help strengthen our sense of security and thus calm our turbulent emotions.

When fears narrow your vision

Unfortunately, fears often create tunnel vision:

• The threat posed by the unknown virus causes stress – and when stressed, attention is focused on the danger.
• If the danger persists, a so-called problem trance can develop. This is because our brains tend to imagine situations as worse than they actually are: our minds automatically play out a horror movie.

It's a good thing there aren't only horror movies.

There isn't just one genre of film. The counterpart to the horror film is the romantic comedy with a happy ending: "Reconciliation – passionate kiss – pan to the rising sun – cut." However, we can't make it that simple in pandemic times. Magical thinking ("It'll all be alright...") and unbridled optimism ("We won't get it!") are inappropriate in the face of a real danger. But neither are pessimism and apocalyptic paralysis.

Resilience is required.

Anyone who heard the presentation „Fall down, get up, straighten your crown, move on“ at the Alpha1 information day in 2018 may remember the corresponding technical term: Resilience is required.

This psychological resilience provides the guidelines for a realistically optimistic scenario. In the film industry, this realistically optimistic script most closely corresponds to the fictional category of "coming of age" or the "best practice" documentary.

Perhaps you're already starting to see how it works: By taking the director's chair for your "Corona" film, you regain agency. You leave the emotional realm of paralyzing fear and enter the emotional realm of productive tension.

As a director, you can use the principles of resilience as a guide. Whether you choose to create a coming-of-age story or a documentary about a success story, this approach utilizes your ability to see something positive in the current situation.

Direction 1: Notice the focus and readjust if necessary.

What you feel is determined by the focus of your attention. So ask yourself:

• What am I currently focusing my attention on?
• What information do I consume? What are its sources?
• Why am I doing this? What effect does it have on me? What will it lead to?
• What other areas are there that I can focus my attention on?

Direction 2: Switch from macro to wide-angle

You probably know this from your own experience: Stress quickly leads to tunnel vision. Try actively and creatively to broaden your perspective:

• Don't look for THE ONE perfect solution, but collect at least 7 solutions – even totally crazy ones are allowed.
• Try using "paradoxical intention": How can I make the situation really worse – to the point of catastrophe?
• Imagine how your "role model" would handle the situation – based on the motto: "What would XY do?"„

Stage direction 3: Use the feedback diary

Those who have diligently gathered positive feedback and connect with these strengths during crises are better equipped to navigate difficult times. So ask yourself:

• What skills and qualities do others particularly value in me?
• How do people who know me well describe my skills?
• How can I remind myself of my strengths in everyday life (e.g., through a feedback journal)?

Director's instruction 4: Accept the weather on set

This applies not only to directors on location shoots: you can't control the weather, but it's always there. Therefore, use all the techniques you know for dealing with it.
You have learned something unchangeable. The basic principle is: I cannot change the situation, but I can change my attitude towards the situation.

Stage direction 5: Ask the magic question

All resilience studies indicate that there's a magic question that can sustainably strengthen mental resilience. Do you know what this magic question is? It's quite simple: What am I grateful for?

This question also forms the basis for the frequently recommended and extremely effective gratitude journal:

• Every evening, write down at least 5 things you are grateful for that day.
• Regularly, sincerely, and as specifically as possible, thank the people you are grateful to for something.

Stage direction 6: Tell your hero's story

You've made it this far in your life. You can consciously tell this story as a "hero's tale":

• What crises have I overcome?
• What exactly challenged me there?
• What strengths have I developed as a result?

Director's Instruction 7: Find a gripping film title

Here you can practice what resilience researchers call positive re-appraisal of stress triggers. This is not to be confused with "positive thinking" or sugarcoating. Positive re-appraisal means discovering something positive in the current situation and naming it (preferably humorously).

So find a gripping movie title for your „Corona“
A film, for example, "The Man Who Dances with the Virus" or "The Corona Whisperer." There are no limits to your creativity. And then: Lights, camera, action!