Challenges for Patients and Therapists
When we are living in a silo, it is hard to see what is happening outside the silo—and what is happening in other silos. And with our limited sightline, it is very easy to look only inside our own life and that of a few other people in our personal and work life. Why look outside when we are living with some comfort inside our silo. To seek help for a psychotherapist, we need to leave our silo and are likely to be exposed by our therapist to uncomfortable information and perspectives. While we might be in pain, a voyage outside our silo portends additional pain. Maybe it is best to remain disengaged—and lonely.
American Disengagement
It is particularly challenging to look outside our silo and find that there is a virus swirling around that could enter our own silo and do harm to us. It is challenging because the virus is not widely visible and is easy to ignore. Christakis (2020, p. 204) makes this important observation:
One of the features of COVID-19 that made it hard for people to take the disease seriously was the lack of visible symptoms (in most cases). Cholera kills by copious diarrhea and dehydration, to the point that patients are gaunt. Smallpox is brutally scarring. The bubonic plague was disfiguring and odiferous. The 1918 Spanish flu made people black and blue, and they often died gasping. The visibility of the symptom of these diseases, quite apart from their much higher lethality, galvanized public action. Furthermore, with COVID-19, what little the media could capture visually about the deaths-such as shrouded bodies piled on a nursing-home floor or in the back of a truck-had a surreal, disembodied feel. Thus, because so many sick people were sequestered in health-care facilities or were alone at home with no one to document their suffering when they died, and because reports focused mostly on visible signs of the economic collapse (with pictures of shuttered stores or lines at food banks), Americans did not see how the virus did its awful work. The deaths and even the mourning for COVID-19 victims occurred strangely offstage, making them harder to appreciate.
Given that American silos are tall with thick walls, it becomes even more likely that the virus remains invisible—or at least not immediately relevant to our lives (until it enters our silo). American disengagement breeds American indifferences—and makes the Invisibility of virus-related symptoms and deaths more pernicious in the United States than perhaps in other countries with a more enmeshed culture. A disengaged culture creates silos of knowledge and silos of ignorance. As Christakis (2020, p.205) notes: “. . . of all the societal divisions that emerge in the time of plague, perhaps the most meaningful is the divide between those who know someone who has died and those who do not.”
I have already mentioned that a power law dictates that the acceleration of infection, hospitalization and death will eventually lead to an infiltration of information (if not the actual infection) into virtually all silos—regardless of the dominance of disengagement:
. . . as more people die and as more of us come to know someone who has died or see a death up close, the epidemic will seem more real and more worthy of a coordinated response. For every hundred thousand people who die, there are a million people who were close to them and ten million people who knew them personally. Slowly but surely, as the deaths mount, we will see that this is a problem that affects us all. Christakis (2020, p. 205)
