HOW IS THE human condition under the pandemic corona times we are all facing, different from the usual predicament of humanity, which requires our going about our lives, while knowing, somewhere in the depths of our subconscious, that death may be just around the corner?

Surely, the thought that all it takes is a fatal road accident or a sudden, life-threatening medical event, sometimes comes to mind, whether as we witness such occurrences or undergo them ourselves. And yet, in normal times, most of us succeed in going about our lives as if we had all the time in the world. We may create various contingency plans, take out medical insurance, consult an estate-planning lawyer, revise our wills or even formulate a living will, appoint a trustee for our children, periodically strive to adopt healthier lifestyle solutions. But in so doing, for the most part, we do not succumb to catastrophic thinking, but rather, take things in stride and keep moving along the trajectories of the goals and ambitions we have mapped out for ourselves. To do so, requires defense mechanisms in working order, a healthy dose of denial or disavowal.

This may be a good place to discuss what constitutes unhealthy denial. 

Let us take the case of someone whose physical symptoms require testing, perhaps to rule out some form of cancer. Unhealthy denial means burying one’s head in the sand, and not pursuing the proposed tests that are necessary for an early diagnosis and timely treatment. This form of denial clearly puts the person at risk. A healthy dose of denial means undergoing the proposed tests and yet somehow allowing oneself to take things in stride, without losing a sense of proportion and succumbing to an all-enveloping feeling it is necessarily the end of the world. This requires us to have access to our inner resources of hope and to the extent possible, belief in a higher power (nature, religion, other).

During the pandemic that is transforming the world as we know it, we resort to the same protective measures to minimize, deny or disavow the danger at our very door, not knowing if the virus is already within our home or person. And yet, the epic proportions of life and death in the shadow of the corona virus, the staggering and exponential amounts of infections and deaths in countries such as Italy and China as well in our own domicile, the continuous bombardment by the media with dire predictions and vivid images, whether on TV or other screens, hard as they are to fully grasp, are of such intensity and strength that they challenge and and at times threaten to overturn any defensive measures we may normally employ to keep our fears at bay. 

Neuroception is a term coined by Stephan Porges, the scientist behind polyvagal theory [1] , a theory of how our autonomic nervous system works. During the past few years, polyvagal theory has been further elaborated and applied to treatment (e.g.,  Dana, 2018).

This term comprises two concepts—neuro and perception. Since neuroception refers to an innate process that occurs automatically, it does not involve perception, which would require consciousness. We have an autonomic, built-in surveillance system—neuroception is reflexive and automatic, without the need for an awareness of cues. Before our brain has had time to take stock of what is happening, the autonomic nervous system has already assessed the situation and initiated a response. The autonomic nervous system, in close two-way communication with the central nervous system and the rest of the body (e.g., HPA axis), assesses risk and takes action accordingly. This process takes into account information from the outside world as well as that from the inside—our bodies (e.g., heart, lungs, intestines).

There are three neurally-based states underlying how we react. 

Each one is mediated by a different branch of the autonomic nervous system: the ventral vagal branch, which is associated with social engagement and connection; the sympathetic banch, associated with mobilization and action patterns of fight or flight; the dorsal vagal branch, associated with freeze, dissociation, immobilization, collapse, shutdown.

Neuroception results in gut feelings that indicate where we are on the continuum between safety and needing to respond to threat for our survival. It shifts our overall state, colors our experience—even when we are not aware of the stimulus evoking our somatosensory response. When we register cues of safety, we relax; when we receive cues of danger, we react accordingly.

We communicate primary emotions through facial expressions—our face is like a switchboard [2]. Our eyes search for and send signs of friendship, safety or conversely, danger, as do our ears, which are attuned to the cadence or music of speech, its underlying patterns and rhythms, its pitch and modulations, all of which reflect the underlying tone, streaming beneath and between our words. When the neuroception is one of safety, both sympathetic and dorsal vagal systems are inhibited, and the ventral vagal system takes dominance, the social engagement system associated with a ventral vagal state taking front stage. In contrast, when the neuroception is of a lack of safety and of imminent danger, we will see sympathetic mobilization e.g., Fight of Flight action patterns, or dorsal vagal Freeze or Collapse.