Trish Dribnenki-Pennock stood on her Calgary street, in the June sun, before the mushy husk of her basement condo. Nearly everything she owned was piled on the street like garbage – books, photographs, clothes, even her toilet. A few days earlier, she and her 18-year-old son had abandoned their home to Calgary’s flooding waters, taking the dog, but unable to capture their grumpy cat. She returned to find the place still sloshing with thigh-deep water. Her records and posters, placed high on a shelf by her quick-thinking son, were spared, along with the cat, but the rest was sunk or floating. On that summer afternoon in 2013, with the water receding to mud, a group of friends were helping her rip out what they could to prevent mould.
Someone placed a melting Popsicle in her hand – a delivery from another friend dealing with their own flood issues, neighbourhoods away. “A Popsicle?” she laughed, which was a gift already. She lifted her face to the warm sun, and squeezed the ice out of its white plastic. Helicopters fluttered overhead, and emergency vehicles raced down the street. She was covered in mud from her kitchen that might be sewage. Her home was gone. And she was slurping a Popsicle like a kid. Surrounded by the devastation of her adult life, she experienced a moment of silly, childlike bliss.
Eight years later, she remembers the significance of that friend’s simple kindness still. “She saw me, she knew me and she understood what I needed,” Ms. Dribnenki-Pennock says. “Isn’t that what we all need, to be seen?”
In pandemics and floods and fires, there are grand gestures and daring rescues that save lives, and then there are the simple kindnesses that are life-saving. They are the hug from a stranger in Edmonton when you collapse in tears after an eight-hour drive from your burning city in the oil sands. The friend who drops off dinner, without asking, after your husband, infected with COVID-19, is taken away in an ambulance. The Thursday night drinking buddy who kayaks to your swamped house in Merritt, B.C., to rescue your birds. The little girl who draws a picture to say she is sorry that you lost all your chickens in the flood at Sumas Prairie. Versions of these acts of kindness appear, over and over again, in the stories people tell when the world has flipped upside down, when they remember the fire that ravaged Fort McMurray, Alta., in 2016, the B.C. floods still retreating and this pandemic that seems like it will never end. They are the mushy Popsicles that keep us going. The moments that makes us feel like we aren’t alone.
These simple acts are so powerful, says Shane Sinclair, the founder and director of the Compassion Research Lab at the University of Calgary, because of the message behind them. “The Popsicle is symbolic. It says, ‘you matter enough, I saw and I felt for you, and I did something about it.’”
What defines these moments of connection is that they aren’t random acts. They are different than charity performed at a distance, and more concrete than empathy. They require one human being to acknowledge the specific pain of another, and then to act to ease that pain – the Latin meaning of compassion, Dr. Sinclair observes, is “to suffer with.”
In research, the act of being present is related to social support, and based on the findings of countless studies, it is arguably the most important factor for why some people recover quickly after a traumatic event, and others do not. Even the perception that support is available, if needed, is linked to better outcomes in clinical care. And it’s not only about receiving care; giving support, studies show, is also healing.
What gives resilience the real edge, according to those studies, isn’t innate grit, or an optimistic personality: it’s connection. We learned this during the early months of the pandemic, when life locked down, and people found ways to reach out; when we understood, instinctively, that a wave at grandma’s window was hope-giving, and a rally of gratitude for doctors and nurses was spirit-lifting. We are seeing this right now, in the way communities are pulling together after the floods in British Columbia. But we can also already observe the wear and tear of yet another pandemic wave. That’s in the science, too: People want to move on, and they sometimes grow impatient with those who find moving on difficult.
Yet these waning periods are just when society needs a booster shot of communal kindness, because what used to be normal wasn’t working for many people. Modern, urban life has long been eroding social support. Years before the virus locked the world up, experts were raising the alarm about loneliness, about the growing percentage of respondents in surveys who said they had no one to trust with their problems.
That’s particularly concerning because while the demand for mental-health care is rising, Canada’s supply of psychiatrists, publicly funded psychologists and social workers is shrinking. But even if the people most in need could easily access the best treatments, even if there were enough clinicians to deliver them – which, in Canada, there are not – therapy and medication can’t do the job alone. What the science shows, and what life teaches, is that what we need after these many months of forced isolation, after the floods and the fires, is to sustain a community of compassion, the kind that doesn’t burn out when the crisis is over. As Ms. Dribnenki-Pennock, the Calgary flood survivor and now pandemic front-line health care worker, knows all too well: We can’t heal alone.
Last December, Therese Greenwood went shopping for a Christmas cactus at the Walmart in Fort McMurray, only to find them sold out. The cactus had become a new tradition ever since The Beast, as the 2016 fire has come to be known, had destroyed her home, and much of the city. The first winter after the fire, Christmas trees and decorations were in short supply. It felt like they should be prioritized for families with young children, Ms. Greenwood says, so she and her husband celebrated with a wilty, nearly leafless, cactus. The plant had become a symbol of hardy survival, and to not have one in a pandemic year, after a spring flood forced them to evacuate – yet again – from their house, felt like a new grief. But Ms. Greenwood got to talking with the woman at the Walmart, who asked where she was living during the fire. “Abbasand,” Ms. Greenwood said. “Beacon Hill,” the woman answered, placing them both in neighbourhoods that had been hardest hit. “I will put in a special order.” The cactus arrived within a week.
Even all these years later, people who lived through The Beast share a common language. “They just know how you are feeling,” says Ms. Greenwood, who has written a book about the fire, What You Take With You. One of the non-material takeaways is the importance of community, of having friends who actively listen, without prying, when you want to talk, and the small acts that make a large impact. The January after the fire, Ms. Greenwood was shopping in a pair of rubber boots – she hadn’t gotten around to buying winter ones. A friend she met in passing noticed, and a few days later, she received a gift card for new boots. “It really helps you to remember that people are good and decent and kind,” she says.
Vincent Agyapong, a psychiatrist then working in Fort McMurray, also evacuated with his family in 2016. In the years that followed, he and a group of researchers have been tracking anxiety and depression rates in those affected by the fire. Their work returned a consistent finding: The more social support a person felt they had, the greater their resilience. People who said they received no social support were 13 times more likely to suffer a major depressive episode after the fire than those who reported receiving high levels of support. Social support was more protective for long-term mental health, Dr. Agyapong says, than receiving financial support for losses suffered during the fire.
Dr. Agyapong’s work was replicating research that goes back decades. A 1982 paper about residents living near the Three Mile Island nuclear power plant found that those reporting social support were more buffered from stress in the aftermath of the disaster. The same finding shows up in studies of firefighters, soldiers, new mothers and children, and after floods, fires, bombings and school shootings. People with post-traumatic stress syndrome who receive clinical care have better outcomes and are more likely to stick with their treatment longer when they feel socially supported. Children who suffer adverse childhood experiences are more resilient when they have at least one adult who they can trust. Military veterans who perceive they have higher levels of social support are less likely to have suicidal thoughts, according to a Yale University study published in November. Researchers at Ohio State University recently found that people who reported giving social support also had lower levels of inflammation, an important indicator of stress and long-term health.
So a hug makes us feel better – did we need studies for that? The problem is that people struggling with trauma and mental-health issues are not always easy to be around, and they don’t always seek out the support they need. They push people away, just when they need their support the most. Or people drift away themselves, or feel unskilled at helping. Research suggests that while social support may be high during or right after a traumatic experience, it can fall away, as people get exhausted or just want to get on with their lives – a fatigue that a pandemic-weary country can no doubt understand.
“It is very difficult when the very thing we need is the first to be lost,” says Susan Rodgers, a psychologist at the University of Western Ontario, who studies how to support mental health and well-being in schools. “We can’t expect relationships to develop by happenstance. It takes intention.”
For months after her husband died, Roshelle Montgomery could not remember her wedding day. She knew the details of the day 10 years ago, but not the feeling of it. She knew that she and Warren saw the movie Grownups on their first date, but she talked about it the way you’d recite the names of the planets, not as something she experienced. She knew that every Sunday, their two little girls would hop into bed, and the four of them would cuddle and be silly, but when she reached for the feeling of those special mornings, she could not find them. They had vanished.
Instead, she remembered, vividly, the day that the ambulance arrived to take Warren to the hospital in April, when he could hardly breathe from COVID-19. She remembered his increasingly panicked texts from the Regina emergency room, before being intubated. She remembered finally getting in to see him, but only at the very end, after the virus had caused a stroke, and he was no longer really Warren any more.
For months, she lived there, trapped in the time she wanted to forget; and unable to reach back to the place she wanted to remember. And yet, when asked in the early fall how she was managing, she talked about the presence of people. All summer long, her family rotated shifts, rarely leaving her on her own, and helping to care for her two daughters. People whose names she didn’t recognize still send random versions of the same note: “Thinking of you, let me know how I can help,” the kind of things people say in a time like this. “It’s not that I would take them up on their offer to help,” she says, “but just the messages made me feel like I wasn’t alone.” Her neighbour, who she barely knew before Warren died, checked in on them regularly, and became a faithful friend. Her daughters’ daycare provider, sensing a bad day when Ms. Montgomery dropped them off in the morning, would have homemade chicken soup ready to go for pickup. She was bolstered emotionally by an online group of young COVID widows like her, who assured her the memory loss was normal and temporary.
And the memories did return, sliding back into her consciousness, as December approached. She credits the support she received – it relieved her stress, and gave her room to grieve. “Everybody, literally, they just wrapped us up,” she says. “And no one’s going to let us fall. I just know that and I am going to be okay.”
Ms. Montgomery has what researchers call a “secure attachment” – she has people she trusts, without worry of being abandoned.
“If I would put my money on any particular dimension of social support that, when enhanced, would help mitigate risk for various outcomes, it would be attachment security,” says Robert Pietrzak, the lead author of the Yale study who researches the role of social support for veterans with PTSD. “Feeling that somebody just gets you, it’s a very powerful thing.”
If you’re lucky, that person or those people exist already. But how does a society create more people like that for those who don’t? How do we build compassion and connection into our health care systems, and develop it in our communities? One obvious strategy is to identify the people who are alone and struggling, and find ways to provide social support to them, in an organized way. Or to deliver a dose of support right when someone needs it most – for instance, in the days or weeks after an emergency related to self-harm. Even brief “caring contacts” can make a difference. In France, a large-scale mental-health program was being tested prepandemic, to make timely, check-in phone calls to every adult who left the hospital after a suicide attempt; similar, smaller pilots are under way in Canada. In several European countries, postal workers, already popping by to deliver the mail, have been trained to check on seniors living alone. Communities in Britain have hired staff to connect people, identified as needing social support, with local groups or clubs; in a number of countries, including Canada, people have been linked to social support by having doctors write “social prescriptions.” A long-standing Finnish program called Circle of Friends sees trained volunteers set up friendships groups, with the idea that they will eventually become self-sustaining.
Dr. Sinclair has also developed a new scale to measure the level of compassionate care that patients are receiving in hospitals and other health care locations – an important step, he argues, to develop practices that foster it. His works suggests this is not only better for patient care, but also for those providing it. “Compassion fatigue” is a myth, he argues. Rather, what contributes more to burnout in health care workers is not having the time or room for compassionate acts with their patients. While his work focuses on making more room for compassion in health care, he suggests the same thinking can be applied in schools and workplaces. “Compassion really has to do with finding ways to look out for the best of a person, even to the point of disadvantaging ourselves to advantage another human,” he says. This view, he points out, is also necessary to solve large-scale problems such as homelessness and climate change – compassion needs to evolve from the individual to the collective. “If we’re just putting little drips of compassion on those problems we’re not getting to those bigger issues.”
Dr. Agyapong, now chair of the psychiatry department at Dalhousie University, also suggests educating people about the two-way benefits of social support, so they think of it like exercise and a healthy diet. Calling a friend, checking up on your elderly neighbour, even listening sympathetically to a stranger at the bus stop – these aren’t just niceties, he says, they are necessary for our mental health, buffering us against difficult times. Being able to care for patients coping with trauma from the fire, Dr. Agyapong says, was key to his own resilience in the months afterward. “I’ve always said the greatest source of protection for mental well-being is really focusing your attention on helping other people.”
Working as a nurse on Vancouver’s east side during the pandemic, Ms. Dribnenki-Pennock saw firsthand the difference that intentional kindness could extend to vulnerable people. “You don’t have to be an expert to say hi, or to listen,” she says. “You just have to be human.”
Being human can just mean paying attention, and pausing for a few minutes – as Dr. Sinclair’s research has shown. He saw it himself seven years ago, when he accompanied his father by ambulance from his long-term-care home to a medical test. Although it was February, a chinook had raised the temperature to nearly 20 degrees. As the attendants were wheeling the gurney to the hospital door, they noticed their patient smile – he had not been outside for weeks. “We’re a little bit early,” the attendants told Dr. Sinclair, not knowing who he was or what he researched. “Why don’t we just stop here, put these blankets around him, and let him soak up the sun?” And they sat on the curb and chatted, until it was time to go inside. His dad died four days later, and Dr. Sinclair has never forgotten that simple act of compassion – a moment of dignity, on a warm, winter day in a hospital parking lot that reminded his father that he mattered.
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