Inside Out

by Maura Pierlot


When COVID-19 first made headlines around the world, my reserve tank was already bone dry. The past three years had been a blur of health crises, hospitals and surgeries, both for myself and my partner, and frequent overseas trips to navigate my mother’s reluctant transition to an assisted living facility. Amidst the chaos, my children’s picture book was published – given the goings-on at the time, an out-of-body experience – and my play on youth mental health issues, Fragments, was produced. I was exhausted – physically, mentally, existentially – and had no goals for the summer except to relax, assuming I remembered how. And rest. But nature had other plans. Bushfires, smoke, hail and floods piggy-backed on each other, an ominous swell gathering strength. If I had been offered a 2020 ‘do-over’ any time prior to March, I would have seized it with both hands.

But not now.

When the new virus crashed into our collective consciousness in February, my first thought was: Thank God my mother died last year because this would have killed her. As it turned out, I didn’t make it to her bedside in time. I tried to convince myself that it didn’t matter. I had said good-bye each time I visited over the years, as though it was my last. And I had begun to mourn her long before her death, when a series of falls uncovered dementia, complicated by the mental health issues she had grappled with all her adult life but refused to face. Issues that made her increasingly combative, occasionally unbearable, often intolerable. The end-game for the slow burn of angst throughout her life, ignited when my father died years earlier. My brothers and I didn’t see it at the time, but that’s when my mother started to pull away from the community she loved, from her family. From life.

The loss of my mother was still raw, and largely unreconciled, when Australia went into lockdown in March. I embraced the enforced hibernation, secretly grateful that I could lay low without expectation or obligation. My anxiety was virtually non-existent. I would have cheerfully noted this to anyone who would listen, if I was able to admit I had anxiety. I’ve always preferred to think of myself as highly strung. A ‘type A’ personality, like my mother. Oddly enough, in my younger days, ‘type A’ was the favoured category, better to be a do-er, someone who tackles life with gusto, not one of those laid-back (read: lazy) type Bs.

With my family under one roof in Canberra there was no need to worry – about kids out at all hours or driving interstate in the fog, or being in the wrong place at the wrong time; no reason to hustle and bustle to the point of exhaustion, trying to be everything to everyone. Perhaps it was because I had been feeling somewhat lost in recent years, though it took a lockdown for me to realise it. The desire to simplify one’s life creeps up without warning, so too does the intolerance for the chatter, chaos and possibilities that defined one’s youth. The result: a gradual shift of gaze from outwards to inwards, the first step towards isolation.

A no-brainer

The correlation between social isolation and mental health issues is hardly new but has been kicked up a notch by COVID-19. Since lockdown, a higher incidence of anxiety and depression has been reported both amongst people with existing mental health issues and the general public. This is a no-brainer. It’s inconceivable to imagine that one’s mental health would actually improve in the face of a pandemic, restricted movement and limited social contact. But for many of the most vulnerable in our society – the elderly, the infirm, the mentally ill – every day is a form of lockdown.

My mother was the social queen of our neighbourhood. All of my friends loved her. Strangers loved her. She was warm, funny, highly opinionated, outspoken, occasionally zany. She was a talented singer, artist and teacher and an amazing chef. Our sprawling house, conveniently located on the main road, was the drop-in zone with additional places routinely set at the dinner table at a moment’s notice. My friends got along so famously with my mother that they continued to visit her long after I placed an ocean between us.

For her family, it was a different story. My mother’s mood, life, dreams and aspirations were limited by anxiety, manifested mostly behind closed doors. The fear, worry and dread that consumed her became weapons in a lifelong war, with her children – and to a lesser extent, her grandchildren – the casualties.

Given our volatile relationship, my mother and I joked that we could never live near each other, but neither of us expected that I’d end up 16,000 kilometres away in Australia – a decision she took decades to accept, if she ever truly did. We spoke weekly on the phone, and I visited nearly every year. But each time I stepped into the house I grew up in, the hostility was palpable. Although delighted to see me, her welcome was always laced with derision. No sooner had I stepped through the front door than she was chiding something I did, or should have done; something I said or implied. With each visit, even before dementia reared its ugly head, I realised something was wrong, that she needed help. She knew so, too, her admissions usually reserved for one of our ceasefires. But the nature of the mental health issues at play prevented her from accepting this truth, let alone acting on it. Maybe I had the problem, she’d fire back at me in the same breath. Maybe I was trying to deal with my guilt for making a life on the other side of the world all those years ago. Maybe I couldn’t handle not being able to fix everything.

Maybe.

It made no sense that my mother drove away the people who loved her most. However, when unable to escape my own thoughts during lockdown, I suddenly realised it made perfect sense. Because her deepest fears, I suspected, were that she’d lose her children– due to distance, illness, emotional detachment or death, whether their own or hers. I figured this out recently when I realised I have the same fears. In an odd way, I was heartened by the revelation. It confirmed what I suspected but never quite knew: that despite often attacking, blaming, humiliating me for transgressions that made sense only to her, my mother did love me. She just didn’t know how to show it.

Isolation syndrome

‘No man is an island,’ John Donne said in his nearly 400-year old meditation on death and rally cry against isolationism. Social connection is wired into our DNA and is the primary way people with mental health issues deal with difficulties. Indeed, the go-to response in times of stress is to reach out to others – for comfort, advice and understanding. Although everyone reacts differently to social isolation, there are some common responses. Fear and worries often increase; there can be changes in sleep patterns, worsening mental health and physical conditions, and increased use of alcohol, tobacco and other substances as coping mechanisms, to name just a few.

Being cut off from others not only rewires our brains but can lead to an altered state of consciousness. Watch a scary movie when alone in the house and routine noises like the whistling of wind through trees or a creak in the floor suddenly seem sinister. People cut off from social contact for long periods (in the physical distancing sense) can experience profound personality and mood changes. Movies like The Shining and Shut In feature isolation as the pretext for madness for good reason. The prolonged reduction of external stimuli during social distancing turns our attention inward – a challenge for many but particularly confronting for people with mental health issues, who are already battling demons within.

During lockdown every third person became a pundit, or so it seemed. The internet was alight with well-meaning advice: how to survive and thrive in an era of physical distancing. We were urged to adopt mindfulness, get enough sleep, watch our nutrition, pump vitamins and exercise regularly. We were told to #stayhome. The problem is you quickly run out of space. My closet is chockers with emotional baggage because unpacking it would be too damn time-consuming. And messy. But without my usual daily distractions, thanks to lockdown, I had no choice but to fling open the suitcase and start rifling through. I thought about my mother, about how I couldn’t help her no matter how hard I tried. I thought about how I fought her all my life because we were so different before realising we were uncannily similar. I thought about my own children and my desire to create for them the childhood that I had wanted. And I thought about how loneliness can creep in even when there are so many people around.

Over a lifetime, I’ve perfected the art of staying busy to avoid thinking about things that are too hard to deal with. Emotional stuff like a traumatic childhood sprinkled with loss. Also an unwillingness, perhaps more of an inability, to grieve, for my father and, more recently, for my mother, along with the countless friends and family lost in between. But avoidance is easier said than done during lockdown. In the face of an existential threat, the walls close in from all directions, and troubling thoughts linger, demanding connection. I wonder if this is how my mother felt when her children moved out, not too long after my father died, and her anxiety slowly morphed into depression. She became increasingly irascible ­– a disposition that I can now see came from a place of fear and possibly abandonment – driving friends and neighbours away. Yes, my mother had dementia, complicated by congestive heart failure, and anxiety, depression and obsessive-compulsive disorder, to name the top three. But she died from a pandemic far more dangerous than COVID-19, one that is ripping through society at breakneck speed.

Loneliness.

The loneliness epidemic

Along with social isolation, loneliness isn’t good for one’s health. People who lack connections are more likely to have lower immune and cognitive function, higher rates of anxiety and depression and shorter life spans. Loneliness can alter cell structure and promote inflammation which, if sustained, can lead to chronic health conditions like heart disease. The risks are heightened for those who are suddenly alone, for example, upon the death of a partner or due to health or mobility issues, with my mother experiencing both. On the other hand, people who engage in meaningful and productive activities benefit from elevated moods and live longer. The key is having a sense of purpose, though finding one isn’t easy. I suspect my mother lost her purpose long ago – or perhaps she gave up, unable to convince herself that her children, although not the sole factors in the equation, were at least part of the product.

Technology needs to shoulder some of the blame for the pandemic of loneliness. Why talk to a person when nearly everything you need is on a device, at least that’s the modus operandi for teenagers who, on average, spend over seven hours a day on theirs, according to the 2019 Common Sense Media study. Everywhere you look, people are wired. Couples and families dine together in restaurants, heads down, scrolling through their feeds with little to no eye contact or conversation. Not that there’s anything innately wrong with being online; the problem is we just don’t how to control it. The even bigger problem: we try to convince ourselves that we do.

Surely, quality social interaction, although not a cure for loneliness, is a promising treatment but even socialising has changed. Pre-internet, socialising meant talking, usually over a cup of tea, on the phone, at dinner. I recall many dinner parties in the ‘80s where, no matter how mind-numbingly boring the topic of conversation, or how arrogant the dinner guest alongside you, you had no choice but to keep the conversation going. There was no phone to check, no sudden emergency at home. Today, socialising often means doing a similar activity alongside each other – think school and community clubs and sport, for example. This makes sense as common interests often bring people together. Yet these types of activities aren’t on offer in times of physical distancing. And talking these days is more trading information, or ‘chatting,’ than a deep and meaningful conversation. Communication is a commodity traded in a virtual world, where face-to-face conversation is losing value. So naturally, when faced with the need for connection (and income) in the COVID-19 climate, many people and businesses quickly adapted their goods and services for online delivery.

Virtual connections

Fortunately, when it comes to virtual connections we’re in the driver’s seat. We can tune in or out. But in a time-pressed world that values hyper-efficiency, there’s a danger that we’ll soon lose the option and online communications will become the new norm. Why bother to shower and dress to meet a friend for drinks – battling traffic, searching for a parking spot, waiting in queues, possibly having to Uber home – when you can catch up on the computer ­with your drink of choice? Not only can you still trade stories and laughs, but it’s cheaper and easier, or so your utilitarian self argues when you opt for an online get-together even when physical distancing restrictions have been eased. It’s a short jaunt from ‘I need to Zoom for convenience’ to ‘I want to Zoom because I can’t be bothered joining the land of the living.’ Likewise, you could call friends and family far away – you miss the sound of their voice – but convince yourself you’re too busy and defer the task, messaging them instead. Interestingly, a 2015 study by the University of California San Diego School of Medicine, found that auditory cues – the comfort of hearing a mother’s voice – produced an oxytocin release in children after a stressful event. Not surprisingly, texting did not.

The real reason you don’t call friends routinely is far more unsettling. You’re so accustomed to texting that a voice call seems … awkward, only warranted when there’s compelling news to share. In fact, your whole outlook on friendship has changed. Your self-worth seems to be measured by the number of online followers/friends and likes/shares and retweets. You count amongst your friends hundreds of people we’ve never met in person or had a conversation with, unless you factor in comments and emojis. You’re smart enough to know something’s amiss. When someone dies, the friend who turns up at your door with a casserole, and the neighbour who sits with you over a cup of tea, offers greater solace than the text messages you receive. As do the voice calls from friends far away, whose imprint on your heart is far deeper than the outpourings from your social media followers.

Research says we’re becoming lonelier and more isolated – and that was pre-COVID-19. Surprisingly, it’s the young and middle-aged who feel the loneliest. But so do the oldest in our communities. In fact, one of the greatest fears of elderly people is that no one nearby cares enough to check on them. We tried to get my mother ‘connected’ – literally and metaphorically – but it was impossible. Given her fear of technology (of anything new, really), and general distrust that mutated into paranoia in later years, she regarded a Wifi connection as an alien invader. She didn’t have the capacity, disposition or interest in connecting online, despite the perceived benefits. All her contemporaries delighted in chatting to their grandchildren online, and so did those lovely elderly people in those sappy TV commercials. Why couldn’t she?

Her lifeline was the telephone –­ a landline, because remembering to charge, let alone, carry a mobile phone eventually proved too difficult for her. She could talk for hours – and we often did. Until dementia took over and she kept talking about the same thing. Again and again. She was pulling away with each phone call, often wanting to hang up within minutes of my call, thinking we had been on for ages. Or she’d call one of the few friends she had left, twenty times in a day, convinced that each call was her first. But friends and neighbours often don’t pick up that something is amiss. If they’re not health-challenged themselves, they’re time or attention-challenged. They think you’re just being annoying.

Where to now?

Lockdown has altered the shape of our lives and, for many, has ushered in, or heightened, a sense of loneliness. We’re encouraged to think of others, not just ourselves – a directive that, for many, seems counterintuitive in the time of a pandemic. Although humans are ‘sociable’ by nature – whatever that means in the 21st century – our primal urge remains survival. With the gradual easing of COVID-19 restrictions, people are rushing outdoors to reclaim their lives and a sense of normality – perhaps ‘new normal’ is more apt as the impact of COVID-19 is likely to be with us for a long time. Yes, we’re likely to be washing our hands for some time, and taking care when gathering in large spaces. But will we also shift our gaze outwards, if a second wave of infection comes – and even if it doesn’t? Will we check on friends and family, and neighbours (especially elderly ones), even when we don’t have the time and energy, or when they don’t seem to appreciate it? To do so, we need to realise that community is more than the sum of its individuals; it is seeing ourselves in each other, whether those close to us or strangers. Cohesion comes from character, not consequences.

Although I no longer want a do-over for 2020, I’m not in any rush to resume my ‘normal’ life. I’m still unpacking the family baggage. Writing helps, revealing new shapes and bringing the ungraspable within reach: That my mother was so much more than the issues she struggled with, and to honour her is to remember this. I don’t know what the path ahead looks like, but I think it involves a sense of otherness, of redrawing the circle to capture imperfection at the edges. And a sense of understanding, that isolation can lead to alienation – the precursor to loneliness. Also, a sense of forgiveness, that I can’t be everything to everyone, but can be something to my family, though first, I need to be something to myself.

If my mother was here, I think she’d understand.


Maura Pierlot is an Australian-American author and playwright living in Canberra. With hope and heart, and occasionally humour, her writing typically explores the intersection of alienation, identity, memory and self. A former ethicist, medical writer and business owner, Maura holds a Ph.D. in philosophy, specialising in ethics.