University of Iowa psychologist takes questions on ‘reentry anxiety’

IOWA CITY — Walking through Eastern Iowa grocery stores, retail outlets or gas stations at any given moment are customers not wearing masks beside others who are.

Some families are limiting their gatherings or keeping them outdoors, while others are hosting large graduation parties, hitting movie theaters, dining at indoor restaurants and swapping Zoom meetings for the real thing in-person.

Although some of those differences depend on who is and is not vaccinated against COVID-19 symptoms, also playing a role is “reentry anxiety” that some Iowans are experiencing after a year of restrictions, distancing, masking and in some cases isolation, according to University of Iowa clinical psychologist Stacey Pawlak.

“Reentry anxiety refers to fear that can accompany letting go of the safeguards that protected us during the COVID-19 pandemic and our reentry into a world that has been changed by the virus,” Pawlak said. “This fear can manifest as a reluctance to switch back to pre-pandemic practices.”

Iowans feeling the hesitancy aren’t alone.

A recent American Psychological Association survey showed nearly half the poll’s 3,000-plus respondents — 49 percent — feel uneasy about “adjusting to in-person interaction.” And vaccinated respondents were just as likely to feel that way as their unvaccinated counterparts.

Pawlak took questions from The Gazette about why the unease, how to manage it, and what it could mean long-term for individuals and the community at large.

Q: For starters, I’m wondering whether you and your colleagues have seen an uptick in clients seeking counseling or mental health services since COVID-19 emerged?

A: “Definitely. We've had a really a significant increase in our referrals,” Pawlak said, noting few specifically say they’re seeking help related to pandemic or reentry concerns. “But I would say in almost every conversation with every person I have, when I'm doing psychotherapy, we're talking about those sorts of issues.”

Q: What sorts of issues are clients facing — and how has COVID-19 or reentry affected them?

A: “It’s absolutely a stressor that has either caused some sort of symptoms of anxiety or sometimes depression, or it's exacerbated those symptoms or those issues that already existed,” she said. “It's just such a big stressor in so many ways. It touches so many lives in so many ways in terms of work, school for your kids, finances, health.”

Q: Are you seeing those mental health challenges affect individuals’ ability to reenter society?

A: Not for everyone, she said.

“Some people are really super excited to throw off their masks and run out and do all the things that they’ve wanted to do for so long,” Pawlak said. “I think there's a certain number of people that don't really have that fear.”

But for others — especially those who took the limits very seriously and made significant changes to their lives — the changed habits can be hard to reverse.

“It takes a lot of time to change into a new habit, and now it's like going back,” Pawlak said. “It's very fearful for a lot of people because you associate not wearing a mask, being close to people, going out in public with ‘I'm going to get sick’ or ‘I'm going to get someone else sick’.”

Q: Is this affecting relationships?

A: Pawlak said it is — especially when some members of a family or friend group still are masking and distancing while others aren’t.

“There's this divide of, ‘I love them and I want to be with them, but I'm worried that being with them will cause problems,’” she said. “That comes up quite a bit in conversations with people I work with.”

Q: Do you think reentry anxieties will simply fade over time? Or will some of these pandemic emotions and the changes be long-lasting?

A: Pawlak said some anxieties and emotional states can be hard to shake. Although she noted not all pandemic-related changes have been bad, and some people might end up sticking with aspects of their COVID-19 routines that initially meant for safety — like working or exercising from home; shopping online; or making their own coffee.

“I'm hopeful that we learn something through this,” she said. “That we discover that it's good to have more time with our family, it's good to engage in good self-care.”

Q: Do you have tips for individuals feeling anxious or fearful about resuming “normal” activities and behaviors?

A: “I tell people it is your own plan, your own schedule that you need to follow, and your best friend, your parents, your sister might be doing something different and that's OK,” she said. “That works for them, and we're not going to worry about their plan or their goals or what they're doing. But for yourself, what do you feel comfortable with?”

Q: Does trying something once make it easier to do again?

A: Yes, Pawlak said, making even the smallest changes meaningful.

“What feels comfortable enough that you can try it?” she said. “Maybe just making a quick trip to the store and seeing what it feels like to not wear your mask. Or getting together with someone in what feels like a safe situation.”

Q: So it’s sort of like testing your vaccine?

A: “Exactly,” she said. “As you gather evidence that refutes whatever negative beliefs you’ve got — like ‘if I go to the store I’m going to get sick, or if I hang out with my friends I’m going to get them sick’ — when you get evidence that’s not true, you start to change the way you’re thinking about that scenario.”

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