Facing Uncertainty

The Covid19 pandemic has caused all of us to live with uncertainty. For a person living with serious illness, daily uncertainty can cause distress and despair. One day the symptoms are under control in the morning and then fly out of control that same afternoon. The body becomes the tyrant who can subvert plans and expectations.

On the website Talentsmart, authors assert that our brains are hardwired from caveman and cavewoman times to react with fear, and likely to overreact, running with the limbic system. They believe the trick is to engage the rational brain rather than the limbic system and offer a list of 11 strategies that are excerpted and included in the list below.
How can members of a palliative care team help patients and their families adjust to the uncertainty of serious illness? Here are some suggested strategies:

• Ask the patient how they experience uncertainty and listen fully, offering empathy and using active listening skills to summarize, reflect what you hear and clarify your understanding of what the patient has expressed.
• Help patients identify the fear response and learn how to spot the emergence of this emotional response. The next step is to engage the rational brain by examining the facts and appraising the fears as irrational, not reality.
• Explore how the transient nature of symptoms can be met with greater resilience when the patterns of change and unreliable trends are accepted as the way it works, rather than expecting the body to be predictable and steady.
• Consider the use of apps or logs to help the patient record ups and downs for themselves. Then at intervals look at the overall trends to see if any larger patterns occur when viewed from that higher level perspective looking at week or months.
• The patient may begin to feel everything is uncertain but that is rarely the case. The trick is to take stock of what is known and what is unknown and assign a factor of importance to each. This sorting and identification can dissipate the power of fears, and be combined with a strategy where the list of unknowns leads to strategies to gather whatever facts they can find.
• “Embracing uncertainty” means knowing the only thing that can be controlled about uncertainty is the process by which decisions are made.
• People who do the best at making decisions in the face of uncertainty don’t waste their time trying to avoid looking foolish. The ability to focus energy on the things that matter most and make informed choices can remove the distraction of fear and worries.
• People who do best with uncertainty imagine different scenarios and develop contingency plans.
• What if? Is a question that can throw “fuel on the fire of stress and worry.”  There are millions of possibilities and the more time spent worrying about possibilities the less time to take action that will help the person calm down and keep stress under control.
• Finding peace in uncertainty is a “Zen habit” and an online article offers another list of strategies.


-Pat Justis, Washington State Department of Health