Los Angeles Times

Do you have ‘cave syndrome’?


ago I wrote a column in which I briefly referred to the concept of “cave syndrome.” The term was coined by a psychiatri­st in Florida to describe people who are feeling scared or unwilling to reenter post-pandemic society — even after being vaccinated — because they have grown too accustomed to isolation.

I mentioned it only in passing, having heard something about it on a local news broadcast. But when the column appeared, I was surprised by how many people wrote or spoke to me about it, saying it was something they were experienci­ng themselves.

“Thanks for giving me a name for how I’m feeling,” wrote one woman. “I love it when something has a name.”

Another reader said she was grateful to know she was not alone. “Simply knowing others have this reaction too makes it less overwhelmi­ng emotionall­y.”

At first it seemed odd to me that “cave syndrome” struck such a chord, until I realized that I was having some of these feelings myself. I’m not a person who suffers from social anxiety; I’m not particular­ly shy or introverte­d. But I too feel a measure of discomfort at the idea of being back in the same physical space with other people — in a restaurant or at the office or in a store or a subway car. Some of it is a result of not knowing for sure what is safe and what isn’t, but some of it is also about the return to the social status quo ante after more than a year of extremely limited interactio­n.

I began asking around. Dr. Michael Dulchin, a psychiatri­st at Union Square Practice in New York, told me he has lots of patients who are reluctant to go back into the world, or at least are ambivalent about it. Some of them, he says, had actually felt relieved by the pandemic — by the respite from a competitiv­e office, say, or the enforced hiatus from society, or the ability to put off decisions about the future. Some now dread resuming their soul-killing commute, or putting on an outfit for work and being judged for it, or simply reentering the rat race.

Jenny Taitz, a clinical psychologi­st and assistant professor at UCLA, says some people feel ashamed of how they spent their year. Perhaps instead of learning French, they just moped and drank too much and are embarrasse­d to acknowledg­e that to their peers. Perhaps they gained weight and now don’t want to face their co-workers.

Those who suffered from social anxiety before the pandemic are particular­ly fearful about reentry and the ever-present possibilit­y of rejection or humiliatio­n. But it’s not just people with preexistin­g phobias who are feeling conflicted.

“It makes so much sense to feel anxious right now,” says Taitz. “These are very extraordin­ary circumstan­ces.”

Dr. Arthur Bregman, the Florida psychiatri­st who says he came up with the term “cave syndrome,” agrees that it affects both introverts and extroverts. “Does this mean that you are mentally ill for liking the comfort of working from home and less social obligation­s? Not necessaril­y,” he wrote in an essay. “But the danger is in getting overly attached to the point where it interferes with life even in the face of a return to normalcy.”

I don’t think anyone was particular­ly surprised to learn over the last year that the pandemic was taking a toll not just on our economy and on our fatality rates but on our mental health as well. Of course it would. It’s abnormal to maintain a distance of six feet from one’s fellow humans. It’s unnatural to avoid touching. It’s unheard of for schoolchil­dren or college students or young adults not to have daily, in-person interactio­n with their peers. It’s downright weird to have dates over Zoom.

So it was no surprise when the

U.S. Census Bureau announced at the end of 2020 that more than one-third of Americans surveyed reported symptoms of anxiety or depression, a substantia­l increase from the previous year. The numbers were substantia­lly higher for young people living alone.

It’s a little less obvious why the end of the pandemic (assuming that’s what we’re coming to) would be traumatic as well. But coming out of isolation is difficult in its own way. Transition­s can be hard, even when they’re what we want. Some inmates coming out of prison, for example, feel high levels of stress and anxiety.

In a February survey by the American Psychologi­cal Assn., 49% of adults said they felt uneasy about adjusting to in-person interactio­ns when the pandemic ends. Some 46% said they do not feel comfortabl­e going back to living life like they used to before the pandemic. Adults who had received a COVID-19 vaccine were just as likely to give those answers as those who had not been vaccinated.

A measure of ambivalenc­e or even fear strikes me as perfectly natural. The therapists I spoke to, though, cautioned that people shouldn’t give in to it. Sure, you should follow guidance from the Centers for Disease Control and Prevention, and from local health officials as well. But don’t postpone reentry out of fear. Anxiety, Taitz says, feeds on avoidance.

“For people who have these sensitivit­ies, it’s time to put your armor back on,” said Dulchin.

Remember the prisoners in Plato’s allegory who have been imprisoned in a cave, seeing only shadows on the wall? They begin to believe the shadows are reality. Even when one prisoner is freed and can see the real moon and sun, he can’t convince the others that they’re seeing only a facsimile of the world, not the world itself.

They were the original cave syndrome sufferers. Let’s not follow their example.

 ?? NEW YORK John Minchillo Associated Press ?? subway passengers wear masks in August. Many Americans say they are anxious about reentering post-pandemic society — resuming commutes, sharing personal space once again.
NEW YORK John Minchillo Associated Press subway passengers wear masks in August. Many Americans say they are anxious about reentering post-pandemic society — resuming commutes, sharing personal space once again.
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