The Pandemic Management Theory. COVID-19 and Biocentric Development

health psychology report ·  Marcus Stueck id original article

The Pandemic Management Theory. COVID-19 and biocentric development

background circle of the model approaches biocentric connections of The Pandemic Management Theory (PMT) is a psychologi- humans to (1) themselves, (2) to others and (3) to the “com- cal theory based on the biocentric health management ap- plex of living elements”, to nature. Maintaining a connec- proach. It uses the data obtained in the study to describe tion in these three levels is necessary to sustain a healthy an external first circle. Six phases of coping with the bur- identity during pandemics. The causes and consequences den of the lockdown and the further load process of the of separations from these levels of life because of biocen- COVID-19 pandemic are defined, such as the orientation tric boundaries, which are defined in the model. phase with load interpretations, acute and chronic phases of negative load consequences and phases with positive conclusions consequences. Furthermore, it describes a phase with To protect the connection of humans to themselves, to oth- a biocentric sustainable change in ethical attitudes to pro- ers and to the complex of living beings (nature) support tect life during pandemics. options are shown in six biocentric fields of action during and after pandemics: (1) maintaining affective communi- participants and procedure cation, (2) maintenance of lively corporeality, (3) contact The empirical base for the description of the Theory is with one’s own identity and inner oriented self-reflexion a study on the psychological processing of the COVID-19 together with others, (4) construction of life sense and ex- crisis. A total of 1500 participants from 5 continents took pression of life potentials, (5) expansion of consciousness part. and perception of the wholeness, (6) development of ecological awareness and sustainable biocentric lifestyles and results attitudes. The COVID-19 crisis is an individual and genre-specific identity crisis in which basic ethical attitudes towards life key words are questioned, where the social distancing and restric- biocentric approach; biocentric development; psychologi- tions have a separating, dissociating effect on the integra- cal coping with pandemic; pandemic management; psy- tion process with different levels of life. Therefore the inner choneuroimmunology and pandemic

organization – DPFA Academy of Work and Health, Leipzig, Germany; International Research Academy BIONET, Leipzig, Germany authors’ contributions – A: Study design · B: Data collection · C: Statistical analysis · D: Data interpretation · E: Manuscript preparation · F: Literature search · G: Funds collection corresponding author – Prof. Dr. habil. Marcus Stueck, DPFA Academy of Work and Health, Täubchenweg 83, 04317 Leipzig, Germany, e-mail: [email protected] to cite this article – Stueck, M. (2021). The Pandemic Management Theory. COVID-19 and biocentric development. Health Psychology Report. https://doi.org/10.5114/hpr.2021.103123 received 09.10.2020 · reviewed 10.11.2020 · accepted 28.11.2020 · published 28.01.2021 Background study that was carried out at the DPFA Academy of Work and Health with 9 international universities The COVID-19 virus first appeared in December 2019 and a total of 1500 participants and began in Ger- in the Chinese city of Wuhan. On March 11, 2020, the many on March 27, 2020, 6 days after the lockdown WHO officially declared the outbreak a pandemic due and has been continued with process surveys. to the rapid increase in infections outside of China. Since its discovery, many scientific papers have been carried out on medical containment and mechanisms Theoretical components of action, especially regarding the medical treatment of the external circle of the virus infection and its symptoms as well as of Pandemic Management Theory Marcus Stueck the organization of treatment in hospitals. There are also a number of studies on how pandemics of this The external sphere of action consists of the coping magnitude affect people who are psychologically af- with the situations of burden during the pandemic fected and burdened by the restrictive governmental and their assessments, which are influenced by sit- measures (Bidzan et al., 2020; Schröder et al., 2020) in uational and habitual factors and coping skills or the short and long term. Röhr et al. (2020) provide an psychological resources. Also, it considers the de- overview of the psychosocial consequences of quar- velopment of negative or positive effects of different antine measures in a systematic review, with quar- subjective load interpretations, which contribute to antine measures being consistently associated with maintaining health or illness (see Figure 2) and the negative psychosocial results in 13 evaluated studies. criteria for the transitions between the model phases These included the occurrence of depressive symp- (Table 3). These components are based on: toms, anxiety, anger, stress, post-traumatic stress, • The Burden-Load-Model about positive and nega- social isolation, loneliness, and stigma. So far, how- tive consequences of load interpretations (Laza- ever, there is no evidence-based and comprehensive rus, 1999; Rohmert & Rutenfranz, 1975; Scheuch theory to describe the psychological effect mecha- & Schröder, 1990; Stueck, 2008), nisms behind the effects of coping with or processing • The Chrono-bio-psychological Burden-Model a pandemic, as e.g. in the event of terrorist attacks (Balzer & Stueck, 2021; Stueck et al., 2005), (Greenberg, 2012; Tichy, 2013). In this theory, fear of • Coping models of loads, illness, disasters and death is assumed to be the central trigger for changes stress prevention (Lazarus & Launier, 1981; Schrö- in self-esteem and the change in cultural values af- der, 1996; Reschke & Schröder, 2000; Stueck, 2009; ter terrorist attacks and has been proven in studies. Muthny, 1990; Horowitz, 2009; Khankeh et al., Fears also play a central role in the COVID-19 crisis, 2021; Witruk et al., 2009), and in the Pandemic Management Theory (PMT), but • Resource models (Antonovsky, 1987; Kobasa, 1990; there are many more fears that occur and have an im- Csikszentmihalyi & Seligman, 2000), pact on the burden experience and on individual and • Works on the model of the zone of the next devel- collective identity and coping processes. The crisis is opment (Vygotskij, 1932/2005; Keiler, 2002). more complex in terms of its existential effects on social and working life and so it can be explained that the theory must also be more complex. The Pandemic The SEVEN phases of the external circle Management Theory contains two circles, which are of the Pandemic Management Theory shown in Figure 1. The outer circle describes seven psychological Based on the empirical observations and the theoret- process phases that individuals can go through in ical background work of the PMT, six phases of dys- dealing with burden and loads during a pandemic. regulation (negative effects) and regulation (positive The inner circle is the centre of the Pandemic Man- effects) towards illness and health during pandemic agement Theory, in which the underlying mecha- periods were defined (see Figure 2). nisms of action behind these seven processing phases are described based on the biocentric man- Phase 1 – Orientation-phase with load interpretations agement approach (Stueck, 2021) and the biocentric of the pandemic situation (Figure 2, field 1-4) approach of Toro (Toro, 2010) and others. These include e.g. the destabilization process of identity In this phase the assessment of the pandemic situ- and the immune system through fear. Strategies for ations by load interpretation of the situation takes action, so-called biocentric fields of action, which place. The pandemic situations in the restriction contribute to overcoming this pandemic crisis and phase have constant situational characteristics, in- the associated destabilization processes as well as cluding the closed borders, social isolation through a ‘biocentric’, life-protecting growth after pandemic exit restrictions, closed public institutions, short- stress are also described. The Pandemic Manage- time work, and mask requirements. A person must ment Theory forms the basis of an international deal adequately with these stimuli, in order to main-

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4 health psychology report tain the balance to the environmental or bodily func- the assessment processes. The assessment processes tions (homeostasis), to achieve goals and to satisfy are also influenced by situational and habitual fac- their needs. The subjective effects of external pan- tors (Figure 2, field 4). Habitual characteristics are demic burdens on people are known as loads that af- personality aspects or behaviour that are inherent to fect people due to their interpretation or assessment behaviour, have become habitual or are integral to of the situation. Two evaluation processes take place the character (Table 1). unconsciously and continuously: At the beginning of a pandemic, in the orientation Situation and reaction-oriented evaluation (Figure 2, phase, positive and negative load reactions arise. field 2): It is assessed whether the situation is a burden, threatening, under-/overwhelming or frustrat- Phase 2 – Phase of the pandemic load reactions ing; or the situation is experienced as a challenge or (Figure 1, field 5) Biocentric health arousing curiosity. management Assessment of coping resources (Figure 2, field 3): It is a phase of short-term adaptability with the fol- and COVID-19 The second assessment answers the question of lowing load reactions depending on the assessment whether the individual has enough capacities to cope of 96 subjects in the first 14 days after the lockdown with the situation. (without load consequences, Table 2). The relationship between burden situations in the The load reactions are processed with routine ac- lockdown or other pandemic situations and load in- tive or inner-psychological coping strategies. This terpretations begins with the perception or trigger- includes the following coping processes: ing of physiological arousal (including cardiovascu- • In the cognitive domain, assimilation and accom- lar parameters or muscle tension (Balzer & Stueck, modation, i.e. classification of the experiences in 2021). This physiological feedback then influences existing or newly created explanatory patterns,

Table 1

Situational and habitual factors which influence the assessment of pandemic situations

Habitual factors (Figure 2, field 4) Situational factors (Figure 2, field 4) • Inside orientation, outside orientation • Coronavirus disease • Anxiety and cognitive styles (suppressors, sensitizers) • Situational social influencing factors • Control beliefs and expectations of political influence • support systems, money or possessions • Risk attitude, overall personality (material aids) • Dysfunctional attitudes and extreme experiences • Family, partnership • Chronobiological and physical factors (chronotype, blood pressure) • Fitness, medical history, age and gender

Table 2

Qualitative responses from 96 people in the first 14 days after lockdown in Germany

Negative load reactions Positive load reactions Mentally (e.g. dealing with the subject of COVID-19, Mentally (e.g. appreciation of the carefree mainly outside orientation) life before COVID-19, inside orientation) Emotional (e.g. fear, frustration and annoyance, anger, Emotional (e.g. rest and relaxation, trust) aggression, mood swings, insecurity, helplessness and carelessness) Physically (e.g. blood pressure rises) Physically (e.g. increased relaxation) Behavioural (avoidance of contact in the personal Behavioural (e.g. slower behaviour, more field, strengthening of contact in the wider environ- structured everyday life, increased contact ment (telephone), more or less movement, change with distant friends, prosocial behaviour, in the daily routine) e.g. more paying attention to others) Experience (disbelief in the face of the worldwide Experience (nature is experienced differently) lockdowns, bewilderment and shock)

 5 but also the initiation of cognition-controlled b) Sub-phase 2 – negative consequences of failure actions. coping with acute negative load emergency signal re- • In the emotional area the transformative obser- actions of sub-phase 1 (Figure 2, field 6b): Only when vation of emotional states takes place (emotion- these attempts to cope with ‘the emergency’ fail over based regulation). After the attempt at coping a re- a long period of time do negative consequences arise. assessment of the person-environment situation is The following negative load interpretation character- undertaken (primary, secondary). The orientation istics can result in: phase does not trigger an emergency signal. • states of fatigue (when load interpretation of overwhelming, overload), Phase 3 – Phase of acute, negative consequences • experiencing monotony (when underwhelming, Marcus Stueck of subjective load interpretations (Figure 2, field 6) underload), • experience of psychological satiety and annoy- If the load reactions in pandemic situations cannot be ance (with frustration) and coped with, acute misuse with negative consequenc- • stress or anxiety reactions (in the case of threat es of load and burden occurs. This phase consists of assessments) (see Figure 3). 2 sub-phases: a) Sub-phase 1 – acute load emergency signal reac- Phase 4 – Phase of chronic symptoms of the negative tions (Figure 2, field 6a): In sub-phase 1 (acute emer- load consequences (Figure 2, field 7) gency signalling), if the negative consequences of the load reactions are not dealt with, load signals that If these acute negative load emergency signal reac- indicate an emergency (problematic thoughts, fear tions of sub-phase 2 over a longer period of time in equivalents, uncertainty, anger, feeling of helpless- a pandemic phase are not managed, then following ness, sadness, post-traumatic reactions) are generat- chronic states of stress or states of fatigue arise (see ed. The level of action is mobilized with the associat- Figure 3). It is a phase of the chronically disturbed ed psychophysiological activation in order to resolve adaptability to the pandemic circumstances with the situation (search for information, direct action, permanent mobilization and the depletion of energy inhibition of action, intrapsychic coping, see chapter reserves. Phase 4 of chronic misuse is accompanied Dealing with negative consequences of pandemic bur- by symptoms such as exhaustion, psychosomatic dis- den and loads). orders, insomnia, inefficient action, self-esteem prob-

Figure 3

Overview about the acute negative load consequences (see Figure 2, field 6)

Load reactions (phase 5) Failure Coping – acute load emergency signal-reactions (sub-phase 1, 6a) Failure Coping – negative consequences (sub-phase 2, 6b)

Overwhelming (Overload) Underwhelming (Underload) Frustration Threat

States of fatigue Experiencing monotony Psychological satiety Stress, anxiety

Hypo- Overloaded sensibility Disturbed autoregulation inhibition

Chronic fatigue Chronic stress, generalized Hypo-sensibility anxiety Hyper-sensibility Failure coping Exhaustion (Phase 4 of chronic symptoms of the negative load consequences) Psychosomatic disorders, insomnia, depression, anxiety, loss of future-orientation Strongly disturbed autoregulation

Psychological and somatic disorder/illness

6 health psychology report lems, loss of future orientation, anxiety, depression, queried. An increase in hypersensitivity was noted loss of recovery, and post-traumatic stress reactions. as the pandemic progressed. Hyper- and hyposen- In phase 4 the autoregulation is vigorously disturbed. sitivity or overload inhibitions are biocentric limits (see chapter Biocentric limits in pandemic situations) Chronobiological reactions during phases 3 and 4 that prevent adaptations to living conditions during the pandemic and an inner psychological and physi- According to the chrono-bio-psychological Burden- cal stability of the biocentric core (for a description Load model of Balzer and Stueck (2021), different of the biocentric core see chapter The biocentric core physiological reactions of the vegetative-emotional of the Pandemic Management Theory), e.g. the im- system, i.e. the sympathetic-hypothalamic activation- mune system as the biological basis of healthy iden- deactivation axis, occur both in the acute (Figure 2, tity. A connection to the inner circle of action of the Biocentric health field 6) and in the chronic negative load consequences Pandemic Management Theory is visible here (for management phase (Figure 2, field 7). This also applies to pandem- a description of the inner circle see chapter Theo- and COVID-19 ics. The activity of this axis can be measured, among retical components of the inner circle of the Pandemic other things, in electrical skin phenomena (electric Management Theory). skin resistance related to sympathetic activity, whereas electric skin potential relates to nerval, parasym- Phase 5 – Phase of onset of illness (Figure 2, field 15) pathetic activity (Balzer, 1980; Balzer & Hecht, 2000a; Boucsein, 2012; Balzer & Stueck, 2021) and blood pres- In phase 5, if the pandemic experiences are not coped sure (Stueck et al., 2016). It plays a role in maintain- with for a longer period, psycho-vegetative reactions ing the health-ensuring auto-regulation mechanisms with disease value with manifested vegetative dis- under pandemic conditions, which ensure the adapta- orders, solidified protection and defence strategies tion to the new pandemic situations by stabilizing the can develop. This stage includes, among other things, ‘Basic-Rest-Activity Circle’ (BRAC-Circle; Kleitman, psychopathological reactions (depression, phobias, 1982; Hecht, 1993; Rossi, 1988). With normal auto- psychosomatic diseases). The symptoms come about regulation, e.g. in orientation phase (Figure 2, field 5), as compensation phenomena for the disease-causing 70% physiological activation states alternate with 30% living conditions. deactivation states in this psycho-physiological rest- activity rhythm, in each case in 120-minute periods. Phase 6 – Phase of the positive effects of pandemic It can be assumed that this autoregulative chronobio- situations (Figure 4, field 8) logical rhythm is disrupted in the acute and chronic stress phase in pandemics, with the following physi- As shown in Figure 4, positive coping experiences ological accompanying reactions or physiological and load interpretations during a pandemic can also protective functions: lead to positive effects. If situations are interpreted • First, physiological overload inhibitions occur, as challenges or assessed by means of the curiosity which can be measured as deactivation states in reaction, this can lead to positive load reactions with the skin resistance (Balzer & Hecht, 2000b; Stueck positive consequences (see Table 2). et al., 2005). The physiological overload inhibitions This phase is characterized by an optimistic at- indicate the overload of the emotional-vegetative titude towards life and paves the way to a healthy system due to the pandemic situation, thereby disposition (Figure 4, field 13, 14), whereby health is serving as the first-level protective mechanism viewed from the perspective of salutogenesis (Fig- against overloading of the vegetative-emotional ure 5). As Figure 5 shows, the self-regulatory reduc- system in phase 2. tion of internal tension counts as the pre-determined • Second, failure to cope with the negative effects breaking point between illness (discomfort, patho- of negative load consequences leads to unspecific genesis) and health (well-being, salutogenesis), as neural activation, measurable in terms of the skin a turning point for the body to shift towards healthy potential, and an associated hypersensitivity (in- autoregulation and adaptative learning. According to crease in the neural activity of the skin potential) this concept, illness and health represent a process as the second level of protection. These hypersen- rather than a state (Figure 5). sitive states occur with chronic stress states (Bal- The process character of health (H–, H+) is sup- zer & Stueck, 2021). ported by internal and external resources (including • Third, failure to cope then leads to states of fatigue self-efficacy, psychosocial support, Figure 4, field 12) or exhaustion which can be measured as a de- and protectives factors, such as sense of coherence crease in the activity of the skin potential and an (Sense of Coherence, see Figure 4, field 12), which associated hyposensitivity (Balzer & Stueck, 2021; is made up of the components of comprehensibility Stueck et al., 2005). (ability to analyse the situation for its causes) and In the study on the pandemic management the- manageability (knowledge of one’s own resources) ory, the hyper- and hyposensitivity could only be and meaningfulness (meaningfulness of coping at-

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8 health psychology report tempts). As described in chapter The biocentric core Figure 5 of the Pandemic Management Theory, next to the psychological coping strategies, also the activity of the Salutogenic model biocentric core and the activities in the biocentric fields of action play an important role to maintain STRESSOR health and wellbeing in times of pandemics (see Fig- ure 2, field 17). H- H+ Phase 7 – Zone of the next sustainable biocentric SALUTOGENESIS development (Figure 1, field 9) TENSION Biocentric health In Phase 6 successful autoregulative and adaptive management biological mechanisms of homeostasis (balance) take PATHOGENESIS and COVID-19 place (see Figure 4, field 8). In Phase 7 (see Figure 4, BREAKDOWN field 9) ‘developmental autopoietic leaps (= jumps)’ can be observed first in biological functions (e.g. central nervous system, hormonal and immunological rate (Balzer & Stueck, 2021) and skin response (Balzer system), which refers to the eternal movement to- & Hecht, 2000a). Also, it has been demonstrated that, wards evolution (according to the main law of life). if synchronization and de-synchronization processes This biological evolution then transfers to psycho- for several parameters occur in an alternate fashion, logical dimensions in a self-organizing manner, e.g. the alternations were correlated with the muscle ten- associated with an increase in well-being and mood sion, skin resistance and skin potential (Balzer, 2009; changes or ethical attitudes towards life values (bio- Stück et al., 2005). Stueck et al. (2009) have reported centric values, e.g. affective connection and sensibil- the autopoietic leaps in a time series of immunoglob- ity towards nature as a complex of living beings and ulin A because of Biodanza in comparison to a Yoga protection of it), for instance as a result of Biodanza intervention (Stueck et al., 2003, 2009). Important (Toro, 2010; Stueck & Villegas, 2009, 2021). This sus- resources for the development of ‘autopoietic leaps’, tainable biocentric evolution can be measured by which take an individual into the zone of the next parameters of psychological development, e.g. in development (Vygotskij, 1932/2005; Keiler, 2002) are questions about sustainably determined changes in considered in the Pandemic Management Theory in behaviour within the pandemic period of the lock- the following aspects: down, with regard to sustainable nutrition (e.g. ques- • creative, authentic expression of emotions in Bio- tion: ‘an ecologically conscious food has become my danza (Toro, 2010; Stueck & Villegas, 2009; Stueck most important in life’…), ecological awareness (e.g. et al., 2019), ‘protecting the environment.’), empathic behaviour • development of trust, e.g. in the ‘Network of Life’, (e.g. a loving affective relationship has become the as a predetermined direction of movement of sys- most important life…’). The psychosocial connections tems (“system-teleonomy”) (Toro, 2010), reducing to the ‘autopoietic leaps’ can only be established from control-ambitions (Stueck, 2008), this biological perspective (Maturana 2011; Stueck, • development of affectivity (ability to have em- 2020a). The term ‘autopoiesis’ was coined by Mat- pathy in action) (Toro, 2010; Stueck et al., 2013), urana and Varela (1991) as a biological concept and ‘group communication in feedback’ on a psycho- means ‘self-creation’ (ancient Greek: autos – self and logical level (Stueck, 2010), poiein – create, build). It describes the process of cre- • autonomy of the involved system parameters ating and maintaining a system itself. The term ‘au- (Maturana, 2002; Stueck, 2010), topoietic developmental leap’ was defined by Stueck • communication processes between the psycho- (2021) in the context of the Pandemic Management neuro-immunological parameters in the biocentric Theory on the base of the Biocentric Health Man- core (Schedlowski, 1994; Sack et al., 1998; Koelsch agement model. It is a processes of “transtasis” as an et al., 2016). inner transformation to another evolutive step of in- The processes of transtasis (autopoietic leaps) and tegration (Toro, 2010) on the basis of the theory of hu- autoregulation run continuously and autonomously man evolution by Toro (2010), the autopoiesis model in the background in the central nervous system, (Maturana & Varela, 1991) and the model approach hormonal and immune systems (see biocentric core, to synchronisation and desynchronisation (Balzer, chapter The biocentric core of the Pandemic Manage- 2009; Balzer & Stueck, 2021). Autopoietic leaps are ment Theory). They are stimulated by the biocentric caused by ‘leaps’ in biological systems, when they fields of action (section Biocentric fields of action and enter crisis-like states, which creates a jump (devel- biocentric health management in pandemics) and in- opmental leap) to a different level (“transtasis”), e.g. fluence the development of a healthy identity (cri- clearly reflected in chronobiologically analysed heart terias see Table 7) and health-promoting well-being.

 9 The path includes the orientation towards feelings Emotion-centred palliative coping (internal cop- of happiness (life has meaning, enjoyment, commit- ing, Figure 2, field 10): This involves influencing ment), personal maturation after pandemic stress and regulating the inner milieu (including physical and post-traumatic growth processes. emotional reactions in acute stressful situations, muscle tension, self-reflections) in order to cope with burden or load states and their negative ef- Criteria for the phase transitions fects. Individuals who can reflect internal processes well and who are not very externally oriented and The negative ‘predetermined breaking points’, i.e. dependent on the outside world have a good chance the places in which the individual moves to the next of coping well with pandemics. The aim of influ- negative stress phases 6 and 7 or positive phases 8 Marcus Stueck encing is to prevent over- or understimulation that and 9 (Figures 2, 4) in pandemic situations are visible would reduce performance (Yerkes Dodson’s law). and measurable using the criteria selected in Table 3. Further health promoting activities during pandemics are shown in Table 4 (Lazarus & Launier, 1981; Kemper & Lazarus, 1992; Scheuch & Schröder, 1990; Dealing with negative consequences Schröder, 1996). of pandemic burden and loads The following concrete preventive measures can be proposed by the government to cope with a pan- In the study on the Pandemic Management Theory 35% demic (Khankeh et al., 2021): of tested subjects (n = 403, German sample) showed Entry point control / traffic restrictions. fear of becoming sick themselves and 1.7% developed Risk communication: management of rumours, symptoms characteristic for COVID19. This incidence clear information with scientific evidence, no unre- rate is thus above the average of the overall incidence alistic assurances, avoidance of misinterpretation of rate in Germany (1.9% in May 2020). Nonetheless, 98% the low disease risk. of the healthy community has to cope with the daily For human resource management in healthcare pandemic circumstances. The coping efforts trigger facilities and hospitals: national guidelines and pro- an assessment process that can lead to the re-eval- tocols for staff protection, staff scheduling, volun- uation of the original primary and secondary assess- teer and retiree management, quarantine for staff in ment (Figure 2, fields 1-4). This re-evaluation process health centres, psychological first aid for staff. enables individual persons to continuously adapt to The monitoring system, patient flow: free diag- the constantly changing person-environment trans- nostic and treatment tests for patients, well-trained action. Two coping strategies can be used in the self- medical staff and the necessary equipment, establish- management process of pandemics: ment of field hospitals. Problem-oriented instrumental coping (external Resource management and cross-organizational coping, Figure 2, field 10): This strategy involves the coordination: personal protective equipment (PPE), stress-generating conditions being influenced by the ventilators, oxygen and diagnostic kits. person (Schröder, 1996). This can be achieved for ex- Vulnerable groups’ management: protecting vul- ample through problem-solving action or through nerable groups, including the elderly, people with changes in communication behaviour, the situation, underlying diseases, identification and provision of own values and the daily routine (especially time financial support packages for vulnerable and low- management and communication behaviour during income groups, tax breaks for vulnerable groups, pandemics). provision of free treatment costs for infected people.

Table 3

Criteria for impaired autoregulatory ability

Criterion Negative load phases Positive load phases Cognitive as stress-threat, frustration-psychological satiety, as challenge and curiosity assessments overload, underload-monotony, fatigue (Figure 3) Emotional reactions e.g. sadness, anger, hope and resignation, fear, e.g. optimism, well-being discomfort Coping lack of coping with stressful situations successful coping and (observable in symptoms and duration) leaps in development Autoregulatory ability limited ability to relax with physiological reactions successful ability to relax

10 health psychology report Table 4

Four activities of health-promoting psychological self-management

Information search and healthy handling of information: Is used to obtain clues to change the way you view the problem. In the study accompanying the PMT, different types of information absorption and processing were found. The displacers need less information, whereas the sensitizers require a lot of information. Direct action: Serves for the immediate change of burden conditions (instrumental aspect) or for the direct regulation of unpleasant emotions when burden occurs (palliative aspect), e.g. • By performing relaxation, well-being is achieved. Biocentric health • Action-related forms of coping as reactions to the topic of illness, e.g. distraction and self-develop- management ment or active problem-oriented coping. and COVID-19 • Creativity as important resource to regulate emotions to express one’s own identity and autonomy. • The ability to set boundaries (e.g. towards the employer in the home office) and express needs (such as relaxation) is an important psychological ability to ultimately stabilize the immune system. Inhibition of unhealthy and ineffective actions during pandemics: • In pandemic situations, there is an imbalance towards too much or too little exercise. • Eating behaviour is also different, which leads to weight changes. • Drinking behaviour is restricted under social isolation conditions (Balzer & Stueck, 2021) Intrapsychic coping processes: • Cognitive processes for the regulation of emotions, for the restoration of well-being, for self- relaxation or positive change in the perception of the situation (distraction, trivialization, denial, intellectualization, self-encouragement). • Cognitive forms of coping with illness and death (e.g. giving the illness a meaning, searching for religiosity, death meditation). Maintaining a healthy relationship to physicality: This applies to personal hygiene but also to the daily practice of yoga, tai chi, breath-oriented meditation, dancing. Emotional forms of coping as preconscious to conscious emotional attitudes towards the illness (e.g. depressive processing).

Social and psychosocial support: increasing social of identity and relationship to others and nature. This participation leads to an improvement in social trust anthropocentric and biocentric shift in the theory is and social engagement, participatory approaches explained in the next chapter. such as community participation to support vulnerable groups, creating social distance, pursuing and checking active contacts. From the anthropocentric to the biocentric paradigm

Theoretical components of the One of the reasons for the emergence of the inner circle of the Pandemic COVID-19 pandemic crisis, among others, lies in Management Theory a problematic, ethically questionable attitude and activities of humans towards wild animals in China, The model components of the Pandemic Manage- where the COVID-19 crisis in Wuhan in December ment Theory described in the previous chapters (situ- 2019 started (as well as the SARS virus pandemic in ation assessment, influencing factors, stress reactions 2002 and 2003). The problematic human-animal rela- and consequences) are traditional anthropocentric tionship is worth looking at in order to prevent fu- burden-load and stress coping model components ture pandemics. There can be observed an increased within psychology and psychotherapy. They answer exploitation of animals and nature in general by hu- the questions in the PMT about the individual bur- mans throughout the whole world. The World Wild- den-load-relationship and how to cope with it dur- life Fund Living Planet Report has noted a dramatic ing a pandemic period. Because of the fact that the decline in species populations on land (68%) and in COVID-19 crisis is an existential individual and a col- water (84%) since 1970 (Almond et al., 2020). The rea- lective identity crisis (Stueck, 2021), the inner circle son for the decline in the Living Planet Index (LPI) describes the biopsychosocial and biocentric aspects is the affective disconnection of humans from nature,

 11 which leads to habitat loss and degradation, including the 19th century. It has been progressively shifting deforestation, driven by how we as humanity produce mankind to a position of a ‘ruler’ of the world that food. Furthermore, because of the human life style controls nature and the processes of life. This com- of exploration rather than sustainability, the human mon conception resulted in the destruction of much species is experiencing a borderline experience with of the planet’s life-upholding resources (for instance climate change, natural disasters, increasing stress, tropical rain forests of the Amazon), without under- depression and exhaustion syndromes that arise from standing of, or regard for the ‘vitality’ of the earth the disorder caused by the modern societies, destroy- as a meta-state and a pre-requisite for the very ex- ing their health and their ability to relate. Here, a par- istence of the life systems, including the species of adigm shift is required from the egocentric worldview man, as attributed by Lovelock (“Gaia hypothesis”, Marcus Stueck of anthropocentric (human centred) to biocentric (life Lovelock, 2007). In this respect, the COVID-19 is not centred) in all areas of science and life. In doing so, just an individual, but also a genre-specific identity a choice of co-existence life forms of people and na- crisis that affects the entire affective relationship ture would have to be met (see Figure 6). and the structures and processes of life on this earth. As seen in Figure 6, in the anthropocentric (Greek The idea of the biocentric approach is that of a ‘rela- ‘human’ and Latin centrum ‘centre’) models humans tionship human, the ecological human’ (Toro, 2004, understand themselves as the centre of the worldly 2010). In western culture it is indispensable to restore reality and solve their problems from this egocen- the feeling for the ‘sanctity and holiness of life’, for tric perspective. The accompanying investigation of the ‘enjoyment of life’ (Schweizer, 1961; Toro, 2010), the Pandemic Management Theory shows that the because this biocentric attitude is left behind. Devel- way people live in dealing with their environment oping affectivity, expanded embodied cognition, and and nature has been put to the test since this pan- the expansion of ethical awareness should become demic crisis. According to the Deep Ecology Theory an absolute priority (Toro, 2005). The biocentric ap- (Naess, 2007) maybe instead of using the construct proach as represented here in the Pandemic Man- Nature or Environment, it should be named as a ‘liv- agement Theory is based on the following scientific ing community’ or ‘complex of living beings’ with working definition by Stueck (2021): animals, plants and all living elements in this uni- “The biocentric approach is based on human un- verse. Because the interpretation of the word ‘nature’ derstanding and feeling of being a part of the complex contains unconsciously an anthropocentric meaning of all living beings within this universe, based on af- that nature is perceived as something separated from fective experiences and encounters in feedback. This humans. Until now in the anthropocentric paradigm, affective, loving and empathic connection to oneself, life values that rely on separations and hierarchies to others and to the living community (nature) has to have been developed. The separation of man from be done both in a group context together with others the ‘rest’ of life is an attitude that began along with and by themselves by using the body-oriented, non- the intensifying industrialization at the beginning of verbal and also verbal-reflecting field interventions

Figure 6

Pyramid model of anthropocentrism vs. network model of biocentric cooperation (source: Pinterest)

12 health psychology report out of the six biocentric fields of action (explana- All these authors, among others, have a common tion, see chapter Biocentric fields of action and biocen- belief that humans must radically change their rela- tric health management in pandemics). Through the tionship to nature from the one that values nature creation of affective and loving-empathic life protect- solely for its usefulness to human beings to the one ing thoughts, feelings and behaviours and the inte- that recognizes that nature as a living community gration of instincts, under consideration of existential has an inherent value which needs to be protected needs, also through the inside orientation (reflexion) and to cooperate with it. Toro (2010) approaches the and in connection with the human inner nature and importance of the development of affective relation- its biological and psychological biocentric core- ship to oneself and other human beings as a basis activities (explanation, see chapter The biocentric for a healthy relationship towards nature: “The ge- core of the Pandemic Management Theory), all this nius of our species is not in its intelligence, but in Biocentric health increases the sensibility towards life. This leads to an affectivity which is geared towards tolerance, management a dissolution of the biocentric limits (explanation, compassion, friendship and love. Affectivity makes and COVID-19 see chapter Biocentric limits in pandemic situations), it possible to perceive reality with full meaning, it e.g. reduction of anxieties, to an affective connection connects life and gives facts their essential meaning. with the complex of living beings and with the sanc- It permeates the perception of beauty, imagination tity and holiness of Life and to an increase of the eth- and understanding” (Toro, 2005, p. 9). In addition to ical consciousness and of the aesthetic recognition this important biocentric aspect of affectivity, these of being a part of nature and universe rather than works link the interdisciplinary network of their ap- obsessively attempting to dominate them or being proach to connect with life and propose strategies disconnected from them. It’s a shift from the egocen- for protecting it in systems of education, medicine, tric, disconnected human to the ecologic, connected politics, economics, work and psychology. It is an human, that produces a leap towards sustainable de- approach that places the laws that govern and pro- velopment in all areas of science, work, education, tect life as the guide of the pedagogical and meth- health and life.” odological model. The biocentric approach orients This scientific working definition is based, among in various areas of action: personal health but also others, on the works about: collective health, social policies and inclusive mod- • the biocentric principle, biocentric education and els of coexistence of the human community (Benatti, Biodanza of Toro (2004, 2005, 2010), 2020). • the biocentric principles of Cavalcante and Wag- Figure 7 shows a semantic differential as it was ner (2020) and the research on Biodanza (Stueck used in the study accompanying the Pandemic Man- & Villegas, 2009, 2020; see www.bionet.name), agement Theory. It shows the biocentric attitudes • the radical constructivist approach (Maturana, (right) as opposed to the anthropocentric ones (left). 2002; Maturana & Varela, 1991), the Biocentric Health Management Theory (Stueck, 2020a, 2021) and the test battery for measuring biocentric act- The biocentric core of the Pandemic ing (Stueck, 2020b; Delshad et al., 2021), Management Theory • and psychological risk analysis in institutions (“Health Cube”; Stueck, 2010, 2019), The biocentric core was defined within the frame- • and biocentric health management (Stueck, 2021), work of the biocentric identity model in the centre • the ethics and reference towards life of Schweitzer of the Pandemic Management Theory (see Figure 2, (1961, 1999; Barsam, 2008), the ethical behaviour field 17; Figure 9). towards animals, animal welfare and justice (Mayr The Pandemic Management Theory assumes et al., 2010) and plants (Balzer, 2013), that the identity, the ‘being oneself’, has a biologi- • the complexity of life and nature (Morin, 2001), cal origin, as Toro (2010) stated. The biocentric core the fundamentals of knowledge (Morin & Brü- consists of biological psycho-neuro-immunological mann, 2001), processes, especially in the immune system in con- • respectful communication (Rosenberg, 2009; Mül- nection with the central nervous system (CNS), the ler, 2019), autonomy in education and dialog of hormonal system and gene expression or the epigen- cultures (Freire, 2007), school of empathy (Stueck etic influence of genes (so called Biological Biocen- et al., 2013, 2019), deep democracy (Mindell, 1992; tric Identity Circle 1, BIC; Stueck, 2021) (see Figure 4, Lewis & Woodhull, 2018), field 18). The functioning of these biocentric core • environmental biocentric development and un- components (Biological Biocentric Identity Circle 1, derstanding (Lovelock, 1991, 2007) and deep ecol- BIC) is threatened by the pandemic. Pandemics have ogy (Naess, 1989, 1998, 2013), an impact on two processes that are constantly run- • the chronobiopsychological basics of life (Hilde- ning in the biocentric core (see Figure 9): brandt et al., 1998; Stueck et al., 2019; Balzer a) autoregulation (homeostasis), which ensures & Stueck, 2021). adaptation to the environment, and

 13 Figure 7

Anthropocentric versus biocentric attitudes in the world of work (Stueck, 2020a, 2021; modified scheme of Villegas, 2008)

Anthropocentric attitudes Biocentric attitudes Myself, I 1 2 3 4 5 6 7 We Having 1 2 3 4 5 6 7 Being Hierarchy 1 2 3 4 5 6 7 Network Marcus Stueck Short term 1 2 3 4 5 6 7 Sustainable Status-oriented 1 2 3 4 5 6 7 Process-oriented Routine 1 2 3 4 5 6 7 Creative Product-oriented 1 2 3 4 5 6 7 Human-oriented Control 1 2 3 4 5 6 7 Trust, Loving Passive, reacting 1 2 3 4 5 6 7 Proactive acting Problem-oriented 1 2 3 4 5 6 7 Solution-oriented Unconsciously 1 2 3 4 5 6 7 Deliberately, Awareness Lack 1 2 3 4 5 6 7 Abundance Verbal and thinking focussed 1 2 3 4 5 6 7 Experience and action focussed Fast, stress 1 2 3 4 5 6 7 Slow, relaxation Externally oriented 1 2 3 4 5 6 7 Internally observing Imitative 1 2 3 4 5 6 7 Authentic, honest Rational 1 2 3 4 5 6 7 Instinctive Dependent 1 2 3 4 5 6 7 Autonomous Disconnected 1 2 3 4 5 6 7 Connected

b) autopoiesis, which enables ‘developmental the framework of emotions, which in turn exert an leaps’ (transtase) in systems through states of stabil- impact on the hormonal system (Figure 8). ity and instability (process characteristics of life) and The biopsychosocial stress model (see Figure 8; structural characteristics of life (communication in Henry, 1983; Schröder, 1992) shows that stress trig- feedback, establishing connections and autonomous gers increased secretion of adrenocorticotropic hor- reactions). The definition of autopoiesis is based on mone (ACTH), cortisol and catecholamines, thereby Maturana and Varela (1991). triggering depression, helplessness and threat status. These two mechanisms of biological systems were This oscillation between threat (catecholamine-trig- described in the biocentric structure and process gered) and helplessness (ACTH-triggered), between model (Stueck, 2020a, 2021); see also phase 7, chapter hope and resignation (Sisyphus syndrome) is typical The seven phases of the external circle of the Pandemic of pandemic circumstances. The autoregulative ef- Management Theory). The definition of autopoiesis is fects of pandemics on the hormonal system in con- based on Maturana and Varela (1991). They run connection with psychological defence mechanisms can tinuously in the background of the central nervous be shown based on similar stressful situations. In one system (CNS), hormonal and immune systems to of the few studies during the terrorist attacks of 2001, maintain their functioning and development. Stueck and colleagues (2005) demonstrated that the It can be assumed that the function of the life- and stress hormones cortisol and adrenaline increased health-preserving autoregulative and autopoietic during the immediate confrontation with the terror- mechanisms of the endocrine system are threatened ist attacks of September 11, 2001, whereby the infor- by needs during pandemics. Needs such as the need mation was warded off by the conscious mind. Since for environmental control and self-control, the needs we are dealing with a social isolation situation in the for autonomy, self-evolution and social integration. pandemic situation with problematic emotions, it These are states of tension that can be observed in can be assumed that social isolation in the pandemic

14 health psychology report Figure 8

Stress model by Henry (1983; modified by Schröder, 1992)

Threat to social position and need for control Willingness to act

Oscillation Catecholamines (Sisyphus syndrome)

Biocentric health management and COVID-19 Sympathetic-adrenal medulla system Helplessness Control Depression Euphoria Pituitary-adrenal systemi

ACTH ACTH Sympathetic-adrenal medulla system

Relaxation

Catecholamines

restriction phase can impair the immune system as tween identity and identification two processes are a biological basis of our identity, as previously shown constantly running in the background: the inter- (Schedlowski, 1994). The biological ‘core activities’, nally oriented self-reflection and the self-creation the so called biological biocentric circle 1, spread into (see Figure 9). In order to shape their own identity, the basic variables of the psyche: behaviour, emotions, individuals need identification with external mod- cognitions (so called psychological Biocentric Iden- els (Petzold, 2012). The external models are largely tity Circle 2; Stueck, 2021, see Figure 4, field 18) and omitted in pandemics, as public life is very much re- influence the process of identity. The optimal func- stricted in the restriction phase and familiar stimuli tioning of the biological Biocentric Identity Circle 1 from the environment are no longer applicable or (genetic potential, central nervous system, immune have changed. In pandemics the person is left to and hormonal system) and the psychological Biocen- themselves, whereby unpleasant emotions can be in- tric Identity Circle 2 (instincts, needs, emotions, mo- tensified. Self-creation leads to a self-organizing de- tives, aims) are internally and externally stimulated velopment and realization of inherent potential and by the biocentric fields of actions (see Figure 2, fields self-actualization (Rogers, 1959; Braun, 1983; Becker, 19 a-f) and are the basics for health in pandemics. 1989). For this reason, people who develop internal self-reflection as opposed to external perception and creativity are protected from pandemic stress and Biocentric core and identity its psychological consequences, despite the aroused in pandemics emotional state (see chapter Biocentric fields of action and biocentric health management in pandemics). The described biological genesis of identity in the bio- b) The pulsation between individuality (I, ego) and centric core is accompanied by a psychological iden- verbal and non-verbal, social cohesion (we, social group) tity process which, mediated by emotions, cognitive (see Figure 9): These two process levels (a, b), whose processes and behaviours, consists of three processes ‘pulsation’ on both levels is limited by pandemics, are taking place during pandemics in the background: embedded in the biocentric core (Figure 9). An iden- a) The pulsation between identity (myself) and tity crisis arises when this pulsation is not possible identification (imitation): Because of this pulsing be- due to external conditions (e.g. restrictions).

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16 health psychology report As the study accompanying the Pandemic Man- emotions they indicate are disturbed. Through the agement Theory shows, self-reflection and self- biocentric fields of action described in chapter Bio- creation (self-actualization, see aspect “a”) work centric fields of action and biocentric health manage- for those who can maintain an internally oriented ment in pandemics this access can be restored. perception. In the accompanying study, an increased internal orientation of perception was visible in 70% of the test subjects in Germany (n = 403). Inner ori- Body contact and identity in pandemics entation correlates significant with autonomy and the ability to overcome emotional dependency. This The second level of the identity processes (aspect “b”) is a good coping strategy, since the autonomy is lim- running in the biocentric core is about the pulsation between the individuality (the ‘I’) and the verbal and ited by the restrictions in the pandemic situation, Biocentric health but can be maintained or compensated for by inter- non-verbal encounter with the other as well as the management nally oriented self-reflection (feeling perception, ac- physical contact associated with it (social cohesion, and COVID-19 ceptance of what is observed). the ‘we’). Pandemics support separations of connec- c) Instincts and identity: As shown in Figure 9, the tions (dissociations) on all levels (e.g. between im- main psychic components (motivation, emotion, cog- mune system, hormonal system and CNS, between nition, BIC 1) are surrounding the biological biocen- instincts and behaviour, motor activity and sympa- tric core activities (BIC 2) with their consciously and thetic arousal, desire for connection and physical unconsciously occurring activities that mutually in- separation). In the study, 66% said they wanted to be fluence each other at the biopsychological level. The hugged and 29% missed eye contact. The field of vi- motivational factors of behaviour that are positioned sion, which is restricted by wearing masks, also has around the core include drives, instincts, needs, emo- an important function for emotion recognition, em- tions, motives and aims (BIC 2). Instincts are behav- pathy and emotional regulation (Adolphs et al., 1996; ioural dispositions that connect people with life, e.g. Rymarczyk et al., 2019). Touch can be seen as a basic the fight and flight instinct or the survival instinct. existential need (Wagener, 2000). Davis (1994) sum- The survival instinct is very important for pandemics marizes four main areas of meaning of touch: since one faces a threat to life through the risk of in- • biological aspect (physical stimulation), fection or one’s own illness. The signals of life, the in- • communicative aspect (as a transmitter of mes- stincts, are threatened in pandemic periods, but also sages and feelings), because of dissociations in the culture we live in with • psychological aspect (communication of security, a high importance of rational processes in societies safety), which are based on profit-making, exploitation of re- • relationship aspect (ability to trust or to be sensi- sources, suppression of sexuality, and dissociations tive to other people). in many other forms. That is why the relation with It becomes clear how important the requirement death in modern societies is so problematic and pres- to maintain contact in the biocentric core is. The ef- ents one of the sources of anxiety and compensating fects of physical contact are shown in Table 5. behaviour in pandemic or human-made catastrophic circumstances. Studies on mortality salience (awareness of one’s own mortality) in the framework of the Biocentric limits in pandemic situations Terror Management Theory (Greenberg, 2012; Kem- per & Lazarus, 1992) have shown that fear of death A pandemic is a situation of separation, which is why switches off the survival instinct in favour of a men- the stimulation of integration of the elements of the tal defence strategy (Becker, 1997). One of the thesis biocentric identity circles by activating the biocentric of the Pandemic Management Theory is therefore fields of action (see chapter Biocentric fields of action that the identity of people is threatened by more fears and biocentric health management in pandemics) is so than only a fear of death – fear of getting infected and important. The separation between the elements of ill or the fear of losing autonomy, which has an im- the biocentric identity circles (see Figure 9) happens pact on self-esteem and cultural values as well as on because of anxieties and fears, physiological protec- physical experience and thus ultimately on hormonal tion mechanisms, body and social dissociations (bio- and central nervous processes and the stability of the centric limits). The ten most frequently mentioned immune system in the biocentric core (Goldenberg fears in the accompanying study on the Pandemic et al., 2000). Goldenberg et al. (2000) demonstrated Management Theory in Germany n( = 403) were: fear that mortality rates increase the tendency to distance of losing autonomy (70%), fear of getting sick (70%), oneself from one’s own physicality (lively corporeal- fear of losing energy (66%), fear of the future (64%), ity). In addition, after becoming aware of one’s own the fear of entering into a relationship with others mortality, a view on humans which emphasizes the (59%), of setting limits (56%) and of aggression by differences to animals is preferred (Tichy, 2013). Here others (56%). The fear of death was visible in 30% of it becomes clear that the access to instincts and the the cases. Although touch plays an essential role in

 17 our lives and is significantly involved in mental and or reinforced and the value structure shifts. Behind physical health, it is also closely related to the trig- these fears is the trait anxiety, as a personality trait gering of fears (Davis, 1994). In the study of the Pan- (trait characteristic of situational anxiety). It has an demic Management Theory 55% of the 403 subjects influence on the assessment processes in phase 1 stated anxieties of being touched by others (55%) and (see chapter The seven phases of the external circle of touching others (52%) or taking part in group activi- the Pandemic Management Theory) of the pandemic ties (50%). As a conclusion it can be stated that where situations that are responsible for the development the pandemic situations trigger fears, so-called fear of fears. In particular, the fearfulness correlates with boundaries become visible, which prevent a connec- the threat assessment of the pandemic situations. tion between the biocentric core and the external life Here four types of fear processing could be identi- Marcus Stueck processes. Toro (2011) defined 90 anxieties in four fied with the corresponding frequency of occurrence fear boundaries and formulated the request to face during the first restriction phase (see Table 6 March- these fears in order to stay in contact with life: April 2020). • fear of living, e.g. fear of infection, fear of losing The term ‘biocentric limits’ was defined in this autonomy, Pandemic Management Theory in order to clarify • fear of loving, e.g. fear of relating to others, blockages that exist in the ‘biocentric core’ of identi- • fear of expressing oneself, e.g. fear of expressing ty due to limited possibilities for self-creation, auton- anger, setting limits, omy, expansion (self-expression) and social exchange • fear of natural phenomena, fear of death. processes. Biocentric limits prevent people from a) In the Terror Management Theory based on adapting homeostatically to life processes in the out- Greenberg (2012) it is assumed that fears influence side world or b) from venturing into the zone of the people’s self-worth and value system. For Greenberg next development by means of an ‘autopoietic leap’ it was mainly the fear of death that was active during (see Figure 4, field 9). The following biocentric limits terrorist attacks. In the Pandemic Management Theo- can be assumed and can be overcome by the activities ry, we assume much more fears (see above) that have in biocentric action-fields (see Figure 10): an influence on the fact that self-worth, as an evalua- • affective pathologies: lack of self-love (self-de- tive part of the self-concept of identity, is destabilized struction), inhibitions to express oneself, difficul-

Table 5

Study results on the effects of physical contact

Strengthens the immune system, reduces stress and can relieve tension and pain (mechanism of action; Wagener, 2001, cit. in Stueck, 2008). Safety and self-protection are conveyed through touch, which is why the sense of touch and feeling is important for adults into old age (Field, 2003, cit. in Stueck, 2008). A lack of physical closeness can therefore lead to low self-esteem. In addition, it is generally assumed that a lack of physical proximity promotes a pathological form of attachment and relationship (Gloger-Tippelt, 2012). Touch has an influence on the organs, identity, emotionality, self-confidence (Toro, 2010).

Table 6

Cognitive styles of dealing with threatening situations (n = 200, German sample)

Avoidance of unpleasant emotions Low High Anxiety – trait Low Non-defensive, flexible, Repressor, consistent avoidance fear situation-adaptive mode mode 56% 16% High Sensitizer, rigid monitoring mode Highly anxious, inconsistent mode 20% 8%

18 health psychology report ties in contact, devaluation, intolerance towards man-nature, observer-observed, sacred-profane, otherness, egocentrism, individuality, dependence body-soul (Toro, 2010). (Toro, 2010; Stueck et al., 2010), The biocentric limits have an impact on a person’s • physiological protective mechanisms (overload attitude to life (liveliness and vitality), well-being and inhibition, hyper/hyposensitivity – see chapter mental and physical health. Consequences of these The seven phases of the external circle of the Pan- abnormal sensations are susceptibility to infections, demic Management Theory; Balzer & Stueck, 2021), depression and hyperactivity. The connection with • chronic psychophysical consequences of pandem- life is lost (depression, exhaustion with hyposensitiv- ic loads and burdens (e.g. exhaustion, depression, ity states), limits can not longer be set (e.g. in work hyperactivity – see chapter The seven phases of behaviour) and this effects the immune systeme as a the external circle of the Pandemic Management biological basic of identity. Attempts are made to get Biocentric health Theory), in contact with the outside world through hyperac- management • dysregulated evaluations of the situation and per- tive behaviour, although e.g. physiological passivity and COVID-19 manent outside orientation (see chapter The seven (in the sense of an overload inhibition) might already phases of the external circle of the Pandemic Man- indicate the withdrawal behaviour (Balzer & Stueck, agement Theory), 2021). • physical, corporeal dissociations or separations and blockages, for instance between head (thinking) – chest (feeling) – arms (action) (Toro, 2010); Criteria for a healthy biocentric this dissociation is the reason for the ‘emptying’ identity (the body) during pandemics, i.e. changes in the body feeling due to fears and the loss of autonomy The Biocentric Identity Model describes and names (Stueck, 2007), methods on how a healthy identity can be main- • social dissociations (lack of transparency, manip- tained in pandemic situations. Table 7 summarizes ulation, dissociation between morals and ethics, criteria for a healthy identity (Toro, 2010).

Table 7

Criteria of a healthy identity and their feasibility under pandemic conditions (Toro, 2010)

Criteria for healthy identity Effects (German sample) Absence of voluntary aggression We determine the increase in the German sample by means of progress sheets Ability to set limits to external aggression Does not work as measures are defined The ability to escape in the face of a superior Does not work as measures are defined force Survival instinct Does not work Ability to be intimate Works partially within family Experience of constancy (strength) Nothing is firmly predictable in this crisis Maintaining strength (constancy) in the face of Nothing is permanent in this crisis difficulties Self-determination of the contact limits Partly, they are imposed from the outside Lack of authoritarian behaviour / power Authority determines boundaries High level of vitality People are exhausted and tired, hypo- or hyperactive Creative skills Autonomy is restricted, self-creative persons are mentally more healthy Experience of internalization Inner orientation should be strengthened Perception of the other as unique, with unique Contact behaviour is slowed down inner values Behaviour that happens in feedback with reality Relation to reality has changed Movements are in balance of energy and synergy Movements changes due to stress, fast movements

 19 Biocentric fields of action words, art, poetry, the expression is a “sacred” space. and biocentric health management When it asks for feelings (what do you feel about), in pandemics rather than thinking (what do you think about). When the method works to secure and develop As has been shown, the identity crisis triggered by the aspects of healthy identity (see Table 7). pandemics threatens the biological and psychologi- When I work with materials and sounds from na- cal functions in the biocentric core (see chapter The ture (e.g. water, sound of wood, voice, singing) or real biocentric core of the Pandemic Management Theory), sounds from musical instruments. especially a) the malfunction of autoregulation and When the feedback leads to self-reflexion, which self-organisation (autopoiesis), b) the connections to doesn’t get evaluated. Marcus Stueck instincts (e.g. survival instinct) and emotions as the When I get support in crisis or insecurities, and signals of life and c) existential needs as motivators the time to make experiences. to connect with life (e.g. need for environmental con- When the exercises in the method strengthen the trol, self-control, self-development, social integra- empathy in the group and are not focused on a single tion). Therefore, the establishment of the connection person (perspective of the other). through the activities in the biocentric fields of action When the focus of the intervention is on support, is of great importance in pandemics (see Figure 10). not about “what is wrong with you”. One important aspect of the biocentric activities When it includes the body orientation, balance be- is that they take place in group activities whenever tween the body-head-way (polar bear) and the head- possible, to strengthen the affective connection to body-way (penguin) mind in the intervention (see others. This is especially important in pandemics, Figure 10). with the risk of social isolation included. When the method integrates all aspects of life in the The substance and the aim of the biocentric inter- group (all religions, men and women together, inclusion ventions in these six fields are the life itself and the of disabled persons, all ages, animals, e.g. dogs, plants). connection with the ‘holiness’ and the ‘enjoyment’ When the method is oriented in the “here and now” with life. This sanctity of life has been lost in many and is not focused to fast on solutions. cultures and the pandemic crisis as an individual and Table 8 shows the levels of interventions related to genre-specific identity crisis shows the necessary of the biocentric fields of actions. gaining this connection again. The methodology for gaining this connection is in all fields mainly the experiential learning at an affective (emotion-based), Evaluation of the Pandemic so called penguin level (Stueck, 2015), rather than an Management Theory intellectual level (so called polar bear level; Stueck, 2015). Affectivity means developing a feeling-based The theory was evaluated as a part of a study ini- empathic and ethical and aesthetic rather than tiated by the DPFA Academy for Work & Health moralistic and rational connection to all living be- in Leipzig, Germany by inviting nine universities ings and elements around (Toro, 2010, 2002; Stueck worldwide (see Table 9). et al., 2010). The basics of biocentric interventions The German test sample includes a total of 400 test and education were described by Toro (2004, 2005), persons (150 men and 250 women) who had complet- who founded the method of Biodanza. Biocentric ed the long form of the questionnaire. In Germany, the education teaches the inner basics of how to live as study began on March 27, 2020, i.e. seven days after a relationship-oriented and ecological human within the start of the restrictions (March 21, 2020), and last- a natural and cosmical network (Toro, 2005). ed until today with effect and process evaluation. The research instrument used for this, the Health Cube questionnaire (Stueck, 2019) for psychological risk as- Biocentric health management sessment during the COVID-19 crisis, analyses on six in working, education, health levels of analysis the situation (level 1), biopsycholog- related fields for adults ical factors (level 2), biocentric and psychological re- and children sources (levels 3, 4, 5), as well as behavioural and con- ditional preventive interventions for coping (level 6). There are many possibilities to work with biocentric A process questionnaire (Form A, B, C) was then sent interventions. The following criteria describe a bio- out at intervals of seven to ten days. Form D was centric intervention: sent to the subjects 20 days apart further forms were When it works with experiential learning in given until today. The results of the studies were pub- groups by doing and experiencing with all senses and lished in several publications up to now (Bidzan et al., affective contact. 2020; Bidzan-Bluma et al., 2020). Since 2020 there is When the feedback after the experience is not ask- research topic in Frontiers of Psychology (Biocentric ing for an analysis, just for expression of feelings by sustainable development and COVID-19).

20 health psychology report

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 21 Table 8

Biocentric levels

Biocentric fields Interventions Examples (head to body, experiential, and body to head, verbal-reflexive) 1. Affective Affective, feeling based, Identify with own wishes and realize them, self-love and communication connections between self-respect, attitude of self-responsibility and self-cre- to myself, to humans and themselves ation, integration of thinking, feeling and acting, taking others time and being “lazy”, experience of music and movement Marcus Stueck Affective connection to Empathy and affectivity to others in thinking, feeling and other humans acting, poetry of encounter (Biodanza), openness to otherness, to form bonds, develop altruistic behaviour, skills of expression of feelings to others, ability to commu- nicate, stop discrimination, self-destruction, recognition of the other, participation and integration of all group members through “deep democracy”, “warm shower” of affective words to others, poems 2. Expression of Connection of wildness Through music, movement and expression of emotions lively corpore- and instinctiveness of in the group context (Biodanza), development of kin- ality together life aesthetic sensitivity and perception (flowing, coordina- with others tion, eutonia, body enjoyment through gentle massages, caress, organic swimming (warm water) 3. Contact with Development of inner Breathing, meditation (e.g. Vipassana), praying, tai chi, healthy identity orientation relaxation, e.g. autogenic training), vivencia-experience of and inner orien- Biodanza tation together Self-reflection, feedback Self-reflection through verbal feedback questions with others Internal detachment of Internal perception of feelings, authentic expression of dependencies needs and wishes, exercises to challenge yourself, defend- ing one’s own point of view, to set limits and to connect with one’s own strengths Identity through af- Embraces, holding eye-contact, seeing faces, physical fective encounters in contact, caress, creating situations of verbal and nonver- feedback bal encounters with time and in feedback and without interpretations Maintaining autonomy, Aspects of healthy identity, expressing creativity by self- actualization and writing poetry, art, making music, dance, setting limits creative expression to influences that restrict autonomy, to reduce stress, to increase relaxation 4. Experience Stimulating the joy of Biodanza, through common experiences in the social and expression living and the feeling of community, through experiences in vitality, affectivity, of life potentials liveliness creativity, sexuality, transcendence, through questioning together with and critical dialog others Development of life Movement, games activities, such as role-play, story- sense and trust telling and sport in social communities, ‘re-evaluation of experiences’ and the ‘analysis of different points of view and alternatives’, body-mind interventions Experiential integra- Experience-oriented and enjoyable perception of the tion, subjective con- living environment with five senses, phantasy work, im- struction of knowledge agery induced relaxation Table 8 continues

22 health psychology report Table 8

Table 8 continued

Biocentric fields Interventions Examples (head to body, experiential, and body to head, verbal-reflexive) 5. Connection Experience of Organic swimming in warm water, exercises to expand to the whole- “implicit orders”, the consciousness, the integrated trance can be initi- ness “entanglements”, ated by slow music and movement, relaxation processes, regression (Toro, 2010) nature experiences Inclusion Inclusive culture (welcoming, teamwork, recognition), Biocentric health management structures (fairness) and practises (social support, activi- and COVID-19 ties outside work) 6. Ethical Ethical behaviour Increase of sensibility and aesthetic feelings by percep- environmental tion with all senses of art, music, human encounter action and eco- Ecological awareness Looking for a place in nature where we feel comfortable logical aware- (ecologic nest), nonverbal excursions in nature with 5 senses ness of nature Affective connection to Common experience of the complex of living beings (ele- all living elements ments earth, water, fire, air, trees, animals, plants, natural sounds, fruits) with all senses Ecological strategies Design thinking in balance to design feeling and design act- with biocentric ap- ing, sustainability, competitiveness considered from the per- proach spective of ecological stability and shared biocentric goals Note. The “Penguin-Polar bear concept” was developed in the frame of the biocentric health management by Stueck, 2015. It describes two ways of biocentric interventions: a) the way from body to head symbolized by polar bear, e.g. the language of life, non-violent communication by Rosenberg, b) the way from head to body symbolized by penguin, e.g. the dance of life, Biodanza.

Table 9

Study sample and plan

Number of subjects (worldwide, regions) Effect evaluation during n Process-evaluation n After crisis coronavirus crisis 20.05.2020 Health Cube (process) 10.01.2021 Health Cube (post); Health Cube questionnaire planned not in all (effect-pre) countries North Europe (Germany, Poland, 615 Germany Form 900 All United Kingdom, Latvia, A, B, C, D, E Norway, Netherlands) South Europe (Italy, Portugal, 280 All Spain) Africa (South Africa, Ethiopia) 50 South America (Mexico, 190 Argentina, Chile) North America (USA, Canada) 20 South East Asia (Indonesia) 160 A, B Middle East (Iran, Israel) 160 Australia 25 Sum (subjects) 1500 900 N = 2400

 23 Conclusions to the use of a biocentric worldview in contrast to the anthropocentric and egocentric worldview. To be healthy in pandemic periods means to be in • The development of experience-oriented learn- a congruent connection between the biological and ing and biocentric education and teaching for our psychological level and to maintain the basic mecha- children, especially a healthy relationship with nisms of autoregulation and autopoiesis in the bio- oneself, with others and in dealing with nature, is centric core, thus the structural character (connec- of decisive importance for the continued existence tion, communication) and the process character of humanity and the protection of our planet. (stability, instability). The separations from the inner Adults can only take children as far as they have core of the biocentric identity through the triggering already gotten themselves. Marcus Stueck of ‘biocentric limits’ (e.g. anxiety to lose autonomy, to get infected, hypersensitivity) during pandemics are observable in various aspects: Acknowledgements • Lack of empathy, fearful action, lack of sensitivity and lack of motivation to act in daily life in harmony I wish to thank my colleagues at the DPFA Academy with nature and co-existent with its living beings, for Work and Health for support and bringing this rather than from the perspective of the stronger. theory into practise, in particular Franziska Brendel, • Lack of contact and physicality, the increasing Jessica Knietzsch, Sebastian Müller-Haugk, Katja separation between body and mind, between feel- Lorenz, Max Reichel, Romy Turuta, Alexander Gel- ing, thinking and acting, focus on the rational lert and the general manager Cathrin Liebold and rather than on the instinctive. her father Prof. C. Dietz. Likewise, I want to thank • Separation from nature, limited ethical action and Lena Hamann and Donatella Bazzotti for editing and ecological awareness. translating the texts. And I want to thank to the col- • Attitude towards the exploitation of nature as leagues of the international research network for a normal process to ensure economic success. the study “COVID-19 and psychological process- • Unethical treatment of animals and disrespectful ing in the context of biocentric development”: Ma- treatment of their way of life. riola Bidzan, Ilona Bidzan-Bluma, Monika Bidzan The following core messages can be derived from (University of Gdansk, Poland), Ulrich Sack (Leipzig the pandemic management theory for future devel- University, Germany), Edgar Galindo, Adelinda Can- opment in various areas of life (including work, fam- deias (University of Evora, Portugal), Maria Prates ily, education, pandemic self-management): Knoke Budde, Tania Aroujo (University Salvador • Dealing with incorrect stresses during or after de Bahia, Brasil), Dian Veronika Sakti Kaloeti (Uni- pandemics begins with a well-differentiated obser- versitas Diponegoro, Semarang, Indonesia), Hami- vation of the situation and the inner reactions. This dreza Khankeh, Mariam Ranjbar, Juliet Roudini requires reflective accompaniment of thoughts and (University of Social Welfare and Rehabilitation, emotions and an internally oriented perception. Teheran), Gunendra Dissanayake, Asanka Bulatha- • The development of a healthy identity is and will watta, Samudra Senerath (University Colombo, Per- be of crucial importance to cope with pandemics. adenya, Sri Lanka). I also would like to thank the co- In this process, the development of leading through ordinators in the countries: Donatella Bazzotti (Italy), interventions in the biocentric fields of action plays Michelle Dubrreuil Macek (USA), Pilar de la Cueva an important role in the individual and group con- (Spain), Kate Clement (Australia), Alejandra Villegas text (including the development of a lively corpo- (South America), Manju Pöllmann (Austria), Annette reality, maintaining physical, loving and empathic Raykova, Vineta Greaves, Linda Tabore (Latvia). Fur- contact experiences despite tele-communication thermore, a great thank you goes to Alejandra Ville- and an authentic self-expression in the unity of gas (Spain, Argentina) and Giovanna Benatti (Italy) thinking, feeling and acting, communication skills). for translating and editing the biocentric part of the • The development of creative self-expression in theory. I also want to thank my teachers, friends and particular (expression, experience of autonomy, colleagues: Harry Schröder, Konrad Reschke, Evelyn demarcation) is decisive for the health of the im- Witruk, Ulrich Sack, Vuk Savkovic, Hans-Ulrich Bal- mune system as the biological basis of identity. zer, Rolando Toro, Swami Shivananda. • Crises and uncertainties have enormous development potential and lead to lasting changes in attitudes towards life (including trust, process References orientation) and in the dissolution of biocentric limits (fears, protective mechanisms, dissolution Adolphs, R., Damasio, H., Tranel, D., & Damasio, A. R. of blockages, social behaviour). (1996). Cortical systems for the recognition of • Experiences in the COVID-19 pandemic lead to emotion in facial expressions. Journal of Neuro- changes in pro-environmental consciousness and science, 16, 7678–7687.

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 27 Stueck, M., Rigotti, T., Roudini, J., Galindo, E., & Uta- Wagener, U. (2000). Fühlen – Tasten – Begreifen: Be- mi, D. S. (2016). Relationship between blood pres- rührung als Wahrnehmung und Kommunikation sure and psychological features of experience [Feeling – touching – understanding: Touch as and behaviour among teachers. Health Psychol- perception and communication]. Bibliotheks- und ogy Report, 4, 128–136. https://doi.org/10.5114/ Informationssystem der Universität Oldenburg. hpr.2016.56853 Witruk, E., Reschke, K., & Stueck, M. (2009). Psy- Stueck, M., Sakti Kaloeti, V., Villegas, A., & Utami, D. chische Belastungen von Notfallhelfern [Mental (2019). The influence of Biodanza and School of stress of emergency helpers]. Trauma & Gewalt, 3, Empathy verbal – respectful communication on 196–208. the ability to express emotions and needs: a pilot Marcus Stueck study among adults in Indonesia. Health Psychol- ogy Report, 7, 334–340. https://doi.org/10.5114/ hpr.2019.88665 Stueck, M., Schoppe, S., Lahn, F., & Toro, R. (2013). Was nützt es sich in jemanden hineinzuversetzen, ohne zu handeln? [What use is it to put yourself in someone’s shoes without acting?]. ErgoMed – Praktische Arbeitsmedizin, 6, 38–46. Stueck, M., & Villegas, A. (2009). Dance towards health. Schibri. Stueck, M., & Villegas, A. (2021). Science and Biodanza. Unpublished manuscript. Stueck, M., Villegas, A., Bauer, K., Terren, R., Toro, V., & Sack, U. (2009). Psycho-immunological process evaluation of Biodanza. Signum Temporis, 2, 99–113. Stueck, M., Villegas, A., & Toro, R. (2010). Norden trifft Süden oder wie die Eisbären zu den Pinguinen kamen: Nonverbale Aspekte Wertschätzender Kom- munikation in Kindertagesstätten [North meets South or how the polar bears came to the pen- guins: Nonverbal aspects of appreciative communication in day care centers]. Schibri. Stueck, M., Witruk, E., Braun, M., & Sack, U. (2005). What happened at the 11.9. to us? Studies on bio- chemical reactions. Unpublished manuscript. Tichy, L. Z. (2013). Die Terror Management Theorie – Ein kritisches Review mit Bezugnahme auf die Meaning Management Theorie [The Terror Man- agement Theory – a critical review with reference to the Meaning Management Theory]. E-Journal Philosophie der Psychologie, 1–30. Retrieved from http://www.jp.philo.at/texte/TichyL1.pdf Toro, R. (2004). The biocentric principle. International Biocentric Foundation, Biodanzaschule Leipzig. Unpublished manuscript. Toro, R. (2005). The biocentric education. Internation- al Biocentric Foundation, Biodanzaschule Leipzig. Unpublished manuscript. Toro, R. (2010). Das System Biodanza [The Biodanza system]. Tinto-Verlag. Toro, R. (2011). Progetto Minotauro [The Minotaur Project]. Pintore. Villegas, A. (2008). Dance towards health. Schibri. Vygotskij, L. S. (1932/2005). Das Problem der Alters- stufen [The problem of ages]. In J. Lompscher (Ed.), Ausgewählte Schriften [Selected writings] (pp. 53–90). Lehmanns Media.

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