Assessing the emotional impact of a pandemic
By Clinical Psychologist, Professor Roger Baker
The Covid-19 pandemic has brought with it a raft of stresses and trauma that will only fully become apparent as the months and years go by. The British Psychological Society (BPS) has suggested that quarantine alone may “cause a number of negative psychological effects including symptoms of post traumatic stress, anger and confusion. Additional stresses during and after quarantine include stigma, loss of finances, boredom and a lack of supplies and information” (The Psychologist, April 2020). The impact of uncertainty for health service staff, the experience of contracting the virus, having to see relatives suffer the effects of the virus, death of loved ones, or not being able to visit them in hospital are just some of the issues that we see at the moment, and that will continue to take a toll as time goes on.
In assessing the impact of these multiple interlocking traumas and stresses, many clinicians and researchers are uneasy about using diagnostic-based assessments that pathologise and place the emphasis on the individual rather than the exceptional circumstances surrounding their presenting problems.
The Emotional Processing Scale (EPS) is one of a new generation of assessments based on a psychological rather than a medical paradigm. The emotional processing model revolves around assessing the emotional processing style the individual typically uses to assimilate the impact of life events. It provides clinicians and researchers with the sort of information required to conceptualise and assess emotional reactions within an alternative non-diagnostic framework. We have found that the use of the scale tends to normalise and validate the person’s experience.
For some people emotions are an easy and integrated part of their lives which are rarely thought about because they work so well. For others, emotions are a foreign territory, uncharted, not understood, vague and problematic. The more negative and prolonged stressful events become the greater the emotional load that need to be processed and the more important it becomes to health and wellbeing to have an effective emotional processing style.
Writing in Psychology Today, psychologist Elyssa Barbash speculates about the widespread traumatic impact of the coronavirus and, in advising on how to cope, pinpoints the protective nature of emotional processing: “Talk about what you are experiencing. Talk about your thoughts and emotions. Processing what you are experiencing, thinking, and feeling seems to be a protective factor for not advancing to PTSD.”
She also highlights emotional avoidance as one of the impeding mechanisms for effective processing. The Emotional Processing Scale offers the advantage of being able to systematically assess the psychological mechanisms involved in emotional processing, providing an essential scientific platform for researchers and therapists.
The five dimensions of emotional processing that the EPS assesses are: ‘Emotional Openness’: the degree to which the individual allows themselves to feel and express emotions; ‘Controllability of Emotions’: how much control they feel they have over emotions; ‘Facing Emotions’: whether they face or avoid emotional events; ‘Emotional Experience’: how well they understand and are connected with their own emotional life, and ‘Signs of Unprocessed Emotion’: emotional or behavioural signs which indicate the degree to which they have successfully processed important emotional events in their life. As the Covid-19 situation continues, all five subscales will prove useful to assess in those dealing with a range of mental health issues, including post-traumatic stress.
The scale has been used in 20 different languages across the world, and the research evidence suggests that the five subscales are significantly embedded in nearly every psychological disorder, suggesting an underlying emotional substrate to psychopathology.
The BPS reviewed the test in 2016, concluding that an emotional processing scale makes it possible to more fully explore the role of key emotional factors in psychopathology and psychological therapy.
Emotional reactions to the Covid-19 pandemic will very likely be diverse, extensive and prolonged – and the sort of standard assessment framework provided by the Emotional Processing Scale becomes an important reference point in helping to manage the emotional fall-out of this pandemic.