THE SEVEN PHASES OF THE EXTERNAL CIRCLE OF THE PANDEMIC MANAGEMENT THEORY

Based on the empirical observations and the theoretical background work of the PMT, six phases of dysregulation (negative effects) and regulation (positive effects) towards illness and health during pandemic periods were defined (see Figure 2).

Phase 1 – Orientation-phase with load interpretations of the pandemic situation (Figure 2, field 1-4)

In this phase the assessment of the pandemic situations by load interpretation of the situation takes place. The pandemic situations in the restriction phase have constant situational characteristics, including the closed borders, social isolation through exit restrictions, closed public institutions, short-time work, and mask requirements. A person must deal adequately with these stimuli, in order to maintain the balance to the environmental or bodily functions (homeostasis), to achieve goals and to satisfy their needs. The subjective effects of external pandemic burdens on people are known as loads that affect people due to their interpretation or assessment of the situation. Two evaluation processes take place unconsciously and continuously:

Situation and reaction-oriented evaluation (Figure 2, field 2): It is assessed whether the situation is a burden, threatening, under-/overwhelming or frustrating; or the situation is experienced as a challenge or arousing curiosity.

Assessment of coping resources (Figure 2, field 3): The second assessment answers the question of whether the individual has enough capacities to cope with the situation.

The relationship between burden situations in the lockdown or other pandemic situations and load interpretations begins with the perception or triggering of physiological arousal (including cardiovascular parameters or muscle tension (Balzer & Stueck, 2021). This physiological feedback then influences the assessment processes. The assessment processes are also influenced by situational and habitual factors (Figure 2, field 4). Habitual characteristics are personality aspects or behaviour that are inherent to behaviour, have become habitual or are integral to the character (Table 1).

At the beginning of a pandemic, in the orientation phase, positive and negative load reactions arise.

Phase 2 – Phase of the pandemic load reactions (Figure 1, field 5)

It is a phase of short-term adaptability with the following load reactions depending on the assessment of 96 subjects in the first 14 days after the lockdown (without load consequences, Table 2).

The load reactions are processed with routine active or inner-psychological coping strategies. This includes the following coping processes:

Phase 3 – Phase of acute, negative consequences of subjective load interpretations (Figure 2, field 6)

If the load reactions in pandemic situations cannot be coped with, acute misuse with negative consequences of load and burden occurs. This phase consists of 2 sub-phases:

a) Sub-phase 1 – acute load emergency signal reactions (Figure 2, field 6a): In sub-phase 1 (acute emergency signalling), if the negative consequences of the load reactions are not dealt with, load signals that indicate an emergency (problematic thoughts, fear equivalents, uncertainty, anger, feeling of helplessness, sadness, post-traumatic reactions) are generated. The level of action is mobilized with the associated psychophysiological activation in order to resolve the situation (search for information, direct action, inhibition of action, intrapsychic coping, see chapter Dealing with negative consequences of pandemic burden and loads).

b) Sub-phase 2 – negative consequences of failure coping with acute negative load emergency signal reactions of sub-phase 1 (Figure 2, field 6b): Only when these attempts to cope with ‘the emergency’ fail over a long period of time do negative consequences arise. The following negative load interpretation characteristics can result in:

Figure 3

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

Phase 4 – Phase of chronic symptoms of the negative load consequences (Figure 2, field 7)

If these acute negative load emergency signal reactions of sub-phase 2 over a longer period of time in a pandemic phase are not managed, then following chronic states of stress or states of fatigue arise (see Figure 3). It is a phase of the chronically disturbed adaptability to the pandemic circumstances with permanent mobilization and the depletion of energy reserves. Phase 4 of chronic misuse is accompanied by symptoms such as exhaustion, psychosomatic disorders, insomnia, inefficient action, self-esteem problems, loss of future orientation, anxiety, depression, loss of recovery, and post-traumatic stress reactions. In phase 4 the autoregulation is vigorously disturbed.

Chronobiological reactions during phases 3 and 4

According to the chrono-bio-psychological Burden-Load model of Balzer and Stueck (2021), different physiological reactions of the vegetative-emotional system, i.e. the sympathetic-hypothalamic activation-deactivation axis, occur both in the acute (Figure 2, field 6) and in the chronic negative load consequences phase (Figure 2, field 7). This also applies to pandemics. The activity of this axis can be measured, among other things, in electrical skin phenomena (electric skin resistance related to sympathetic activity, whereas electric skin potential relates to nerval, parasympathetic activity (Balzer, 1980; Balzer & Hecht, 2000a; Boucsein, 2012; Balzer & Stueck, 2021) and blood pressure (Stueck et al., 2016). It plays a role in maintaining the health-ensuring auto-regulation mechanisms under pandemic conditions, which ensure the adaptation to the new pandemic situations by stabilizing the ‘Basic-Rest-Activity Circle’ (BRAC-Circle; Kleitman, 1982; Hecht, 1993; Rossi, 1988). With normal autoregulation, e.g. in orientation phase (Figure 2, field 5), 70% physiological activation states alternate with 30% deactivation states in this psycho-physiological rest-activity rhythm, in each case in 120-minute periods. It can be assumed that this autoregulative chronobiological rhythm is disrupted in the acute and chronic stress phase in pandemics, with the following physiological accompanying reactions or physiological protective functions:

In the study on the pandemic management theory, the hyper- and hyposensitivity could only be queried. An increase in hypersensitivity was noted as the pandemic progressed. Hyper- and hyposensitivity or overload inhibitions are biocentric limits (see chapter Biocentric limits in pandemic situations) that prevent adaptations to living conditions during the pandemic and an inner psychological and physical stability of the biocentric core (for a description of the biocentric core see chapter The biocentric core of the Pandemic Management Theory), e.g. the immune system as the biological basis of healthy identity. A connection to the inner circle of action of the Pandemic Management Theory is visible here (for a description of the inner circle see chapter Theoretical components of the inner circle of the Pandemic Management Theory).

Phase 5 – Phase of onset of illness (Figure 2, field 15)

In phase 5, if the pandemic experiences are not coped with for a longer period, psycho-vegetative reactions with disease value with manifested vegetative disorders, solidified protection and defence strategies can develop. This stage includes, among other things, psychopathological reactions (depression, phobias, psychosomatic diseases). The symptoms come about as compensation phenomena for the disease-causing living conditions.

Phase 6 – Phase of the positive effects of pandemic situations (Figure 4, field 8)

As shown in Figure 4, positive coping experiences and load interpretations during a pandemic can also lead to positive effects. If situations are interpreted as challenges or assessed by means of the curiosity reaction, this can lead to positive load reactions with positive consequences (see Table 2).

Figure 4

Positive consequences of load interpretations and successful coping in the Pandemic Management Theory

This phase is characterized by an optimistic attitude towards life and paves the way to a healthy disposition (Figure 4, field 13, 14), whereby health is viewed from the perspective of salutogenesis (Figure 5). As Figure 5 shows, the self-regulatory reduction of internal tension counts as the pre-determined breaking point between illness (discomfort, pathogenesis) and health (well-being, salutogenesis), as a turning point for the body to shift towards healthy autoregulation and adaptative learning. According to this concept, illness and health represent a process rather than a state (Figure 5).

Figure 5

Salutogenic model

The process character of health (H–, H+) is supported by internal and external resources (including self-efficacy, psychosocial support, Figure 4, field 12) and protectives factors, such as sense of coherence (Sense of Coherence, see Figure 4, field 12), which is made up of the components of comprehensibility (ability to analyse the situation for its causes) and manageability (knowledge of one’s own resources) and meaningfulness (meaningfulness of coping attempts). As described in chapter The biocentric core of the Pandemic Management Theory, next to the psychological coping strategies, also the activity of the biocentric core and the activities in the biocentric fields of action play an important role to maintain health and wellbeing in times of pandemics (see Figure 2, field 17).

Phase 7 – Zone of the next sustainable biocentric development (Figure 1, field 9)

In Phase 6 successful autoregulative and adaptive biological mechanisms of homeostasis (balance) take place (see Figure 4, field 8). In Phase 7 (see Figure 4, field 9) ‘developmental autopoietic leaps (= jumps)’ can be observed first in biological functions (e.g. central nervous system, hormonal and immunological system), which refers to the eternal movement towards evolution (according to the main law of life). This biological evolution then transfers to psychological dimensions in a self-organizing manner, e.g. associated with an increase in well-being and mood changes or ethical attitudes towards life values (biocentric values, e.g. affective connection and sensibility towards nature as a complex of living beings and protection of it), for instance as a result of Biodanza (Toro, 2010; Stueck & Villegas, 2009, 2021). This sustainable biocentric evolution can be measured by parameters of psychological development, e.g. in questions about sustainably determined changes in behaviour within the pandemic period of the lockdown, with regard to sustainable nutrition (e.g. question: ‘an ecologically conscious food has become my most important in life’…), ecological awareness (e.g. ‘protecting the environment...’), empathic behaviour (e.g. a loving affective relationship has become the most important life…’). The psychosocial connections to the ‘autopoietic leaps’ can only be established from this biological perspective (Maturana, 2011; Stueck, 2020a). The term ‘autopoiesis’ was coined by Maturana and Varela (1991) as a biological concept and means ‘self-creation’ (ancient Greek: autos – self and poiein – create, build). It describes the process of creating and maintaining a system itself. The term ‘autopoietic developmental leap’ was defined by Stueck (2021) in the context of the Pandemic Management Theory on the base of the Biocentric Health Management model. It is a processes of “transtasis” as an inner transformation to another evolutive step of integration (Toro, 2010) on the basis of the theory of human evolution by Toro (2010), the autopoiesis model (Maturana & Varela, 1991) and the model approach to synchronisation and desynchronisation (Balzer, 2009; Balzer & Stueck, 2021). Autopoietic leaps are caused by ‘leaps’ in biological systems, when they enter crisis-like states, which creates a jump (developmental leap) to a different level (“transtasis”), e.g. clearly reflected in chronobiologically analysed heart rate (Balzer & Stueck, 2021) and skin response (Balzer & Hecht, 2000a). Also, it has been demonstrated that, if synchronization and de-synchronization processes for several parameters occur in an alternate fashion, the alternations were correlated with the muscle tension, skin resistance and skin potential (Balzer, 2009; Stück et al., 2005). Stueck et al. (2009) have reported the autopoietic leaps in a time series of immunoglobulin A because of Biodanza in comparison to a Yoga intervention (Stueck et al., 2003, 2009). Important resources for the development of ‘autopoietic leaps’, which take an individual into the zone of the next development (Vygotskij, 1932/2005; Keiler, 2002) are considered in the Pandemic Management Theory in the following aspects:

The processes of transtasis (autopoietic leaps) and autoregulation run continuously and autonomously in the background in the central nervous system, hormonal and immune systems (see biocentric core, chapter The biocentric core of the Pandemic Management Theory). They are stimulated by the biocentric fields of action (section Biocentric fields of action and biocentric health management in pandemics) and influence the development of a healthy identity (criterias see Table 7) and health-promoting well-being. The path includes the orientation towards feelings of happiness (life has meaning, enjoyment, commitment), personal maturation after pandemic stress and post-traumatic growth processes.

CRITERIA FOR THE PHASE TRANSITIONS

The negative ‘predetermined breaking points’, i.e. the places in which the individual moves to the next negative stress phases 6 and 7 or positive phases 8 and 9 (Figures 2, 4) in pandemic situations are visible and measurable using the criteria selected in Table 3.

DEALING WITH NEGATIVE CONSEQUENCES OF PANDEMIC BURDEN AND LOADS

In the study on the Pandemic Management Theory 35% of tested subjects (n = 403, German sample) showed fear of becoming sick themselves and 1.7% developed symptoms characteristic for COVID19. This incidence rate is thus above the average of the overall incidence rate in Germany (1.9% in May 2020). Nonetheless, 98% of the healthy community has to cope with the daily pandemic circumstances. The coping efforts trigger an assessment process that can lead to the re-evaluation of the original primary and secondary assessment (Figure 2, fields 1-4). This re-evaluation process enables individual persons to continuously adapt to the constantly changing person-environment transaction. Two coping strategies can be used in the self-management process of pandemics:

Problem-oriented instrumental coping (external coping, Figure 2, field 10): This strategy involves the stress-generating conditions being influenced by the person (Schröder, 1996). This can be achieved for example through problem-solving action or through changes in communication behaviour, the situation, own values and the daily routine (especially time management and communication behaviour during pandemics).

Emotion-centred palliative coping (internal coping, Figure 2, field 10): This involves influencing and regulating the inner milieu (including physical emotional reactions in acute stressful situations, muscle tension, self-reflections) in order to cope with burden or load states and their negative effects. Individuals who can reflect internal processes well and who are not very externally oriented and dependent on the outside world have a good chance of coping well with pandemics. The aim of influencing is to prevent over- or understimulation that would reduce performance (Yerkes Dodson’s law). Further health promoting activities during pandemics are shown in Table 4 (Lazarus & Launier, 1981; Kemper & Lazarus, 1992; Scheuch & Schröder, 1990; Schröder, 1996).

The following concrete preventive measures can be proposed by the government to cope with a pandemic (Khankeh et al., 2021):

Entry point control / traffic restrictions.

Risk communication: management of rumours, clear information with scientific evidence, no unrealistic assurances, avoidance of misinterpretation of the low disease risk.

For human resource management in healthcare facilities and hospitals: national guidelines and protocols for staff protection, staff scheduling, volunteer and retiree management, quarantine for staff in health centres, psychological first aid for staff.

The monitoring system, patient flow: free diagnostic and treatment tests for patients, well-trained medical staff and the necessary equipment, establishment of field hospitals.

Resource management and cross-organizational coordination: personal protective equipment (PPE), ventilators, oxygen and diagnostic kits.

Vulnerable groups’ management: protecting vulnerable groups, including the elderly, people with underlying diseases, identification and provision of financial support packages for vulnerable and low-income groups, tax breaks for vulnerable groups, provision of free treatment costs for infected people.

Social and psychosocial support: increasing social participation leads to an improvement in social trust and social engagement, participatory approaches such as community participation to support vulnerable groups, creating social distance, pursuing and checking active contacts.

FROM THE ANTHROPOCENTRIC TO THE BIOCENTRIC PARADIGM

One of the reasons for the emergence of the COVID-19 pandemic crisis, among others, lies in a problematic, ethically questionable attitude and activities of humans towards wild animals in China, where the COVID-19 crisis in Wuhan in December 2019 started (as well as the SARS virus pandemic in 2002 and 2003). The problematic human-animal relationship is worth looking at in order to prevent future pandemics. There can be observed an increased exploitation of animals and nature in general by humans throughout the whole world. The World Wildlife Fund Living Planet Report has noted a dramatic decline in species populations on land (68%) and in water (84%) since 1970 (Almond et al., 2020). The reason for the decline in the Living Planet Index (LPI) is the affective disconnection of humans from nature, which leads to habitat loss and degradation, including deforestation, driven by how we as humanity produce food. Furthermore, because of the human life style of exploration rather than sustainability, the human species is experiencing a borderline experience with climate change, natural disasters, increasing stress, depression and exhaustion syndromes that arise from the disorder caused by the modern societies, destroying their health and their ability to relate. Here, a paradigm shift is required from the egocentric worldview of anthropocentric (human centred) to biocentric (life centred) in all areas of science and life. In doing so, a choice of co-existence life forms of people and nature would have to be met (see Figure 6).

Figure 6

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

As seen in Figure 6, in the anthropocentric (Greek ‘human’ and Latin centrum ‘centre’) models humans understand themselves as the centre of the worldly reality and solve their problems from this egocentric perspective. The accompanying investigation of the Pandemic Management Theory shows that the way people live in dealing with their environment and nature has been put to the test since this pandemic crisis. According to the Deep Ecology Theory (Naess, 2007) maybe instead of using the construct Nature or Environment, it should be named as a ‘living community’ or ‘complex of living beings’ with animals, plants and all living elements in this universe. Because the interpretation of the word ‘nature’ contains unconsciously an anthropocentric meaning that nature is perceived as something separated from humans. Until now in the anthropocentric paradigm, life values that rely on separations and hierarchies have been developed. The separation of man from the ‘rest’ of life is an attitude that began along with the intensifying industrialization at the beginning of the 19th century. It has been progressively shifting mankind to a position of a ‘ruler’ of the world that controls nature and the processes of life. This common conception resulted in the destruction of much of the planet’s life-upholding resources (for instance tropical rain forests of the Amazon), without understanding of, or regard for the ‘vitality’ of the earth as a meta-state and a pre-requisite for the very existence of the life systems, including the species of man, as attributed by Lovelock (“Gaia hypothesis”, Lovelock, 2007). In this respect, the COVID-19 is not just an individual, but also a genre-specific identity crisis that affects the entire affective relationship and the structures and processes of life on this earth. The idea of the biocentric approach is that of a ‘relationship human, the ecological human’ (Toro, 2004, 2010). In western culture it is indispensable to restore the feeling for the ‘sanctity and holiness of life’, for the ‘enjoyment of life’ (Schweizer, 1961; Toro, 2010), because this biocentric attitude is left behind. Developing affectivity, expanded embodied cognition, and the expansion of ethical awareness should become an absolute priority (Toro, 2005). The biocentric approach as represented here in the Pandemic Management Theory is based on the following scientific working definition by Stueck (2021):

“The biocentric approach is based on human understanding and feeling of being a part of the complex of all living beings within this universe, based on affective experiences and encounters in feedback. This affective, loving and empathic connection to oneself, to others and to the living community (nature) has to be done both in a group context together with others and by themselves by using the body-oriented, nonverbal and also verbal-reflecting field interventions out of the six biocentric fields of action (explanation, see chapter Biocentric fields of action and biocentric health management in pandemics). Through the creation of affective and loving-empathic life protecting thoughts, feelings and behaviours and the integration of instincts, under consideration of existential needs, also through the inside orientation (reflexion) and in connection with the human inner nature and its biological and psychological biocentric core-activities (explanation, see chapter The biocentric core of the Pandemic Management Theory), all this increases the sensibility towards life. This leads to a dissolution of the biocentric limits (explanation, see chapter Biocentric limits in pandemic situations), e.g. reduction of anxieties, to an affective connection with the complex of living beings and with the sanctity and holiness of Life and to an increase of the ethical consciousness and of the aesthetic recognition of being a part of nature and universe rather than obsessively attempting to dominate them or being disconnected from them. It’s a shift from the egocentric, disconnected human to the ecologic, connected human, that produces a leap towards sustainable development in all areas of science, work, education, health and life.”

This scientific working definition is based, among others, on the works about:

All these authors, among others, have a common belief that humans must radically change their relationship to nature from the one that values nature solely for its usefulness to human beings to the one that recognizes that nature as a living community has an inherent value which needs to be protected and to cooperate with it. Toro (2010) approaches the importance of the development of affective relationship to oneself and other human beings as a basis for a healthy relationship towards nature: “The genius of our species is not in its intelligence, but in an affectivity which is geared towards tolerance, compassion, friendship and love. Affectivity makes it possible to perceive reality with full meaning, it connects life and gives facts their essential meaning. It permeates the perception of beauty, imagination and understanding” (Toro, 2005, p. 9). In addition to this important biocentric aspect of affectivity, these works link the interdisciplinary network of their approach to connect with life and propose strategies for protecting it in systems of education, medicine, politics, economics, work and psychology. It is an approach that places the laws that govern and protect life as the guide of the pedagogical and methodological model. The biocentric approach orients in various areas of action: personal health but also collective health, social policies and inclusive models of coexistence of the human community (Benatti, 2020).

Figure 7 shows a semantic differential as it was used in the study accompanying the Pandemic Management Theory. It shows the biocentric attitudes (right) as opposed to the anthropocentric ones (left).

Figure 7

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

THE BIOCENTRIC CORE OF THE PANDEMIC MANAGEMENT THEORY

The biocentric core was defined within the framework of the biocentric identity model in the centre of the Pandemic Management Theory (see Figure 2, field 17; Figure 9).

Figure 8

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

Figure 9

The inner sphere of action of the Pandemic Management Theory

The Pandemic Management Theory assumes that the identity, the ‘being oneself’, has a biological origin, as Toro (2010) stated. The biocentric core consists of biological psycho-neuro-immunological processes, especially in the immune system in connection with the central nervous system (CNS), the hormonal system and gene expression or the epigenetic influence of genes (so called Biological Biocentric Identity Circle 1, BIC; Stueck, 2021) (see Figure 4, field 18). The functioning of these biocentric core components (Biological Biocentric Identity Circle 1, BIC) is threatened by the pandemic. Pandemics have an impact on two processes that are constantly running in the biocentric core (see Figure 9):

These two mechanisms of biological systems were described in the biocentric structure and process model (Stueck, 2020a, 2021); see also phase 7, chapter The seven phases of the external circle of the Pandemic Management Theory). The definition of autopoiesis is based on Maturana and Varela (1991). They run continuously in the background of the central nervous system (CNS), hormonal and immune systems to maintain their functioning and development.

It can be assumed that the function of the life- and health-preserving autoregulative and autopoietic mechanisms of the endocrine system are threatened by needs during pandemics. Needs such as the need for environmental control and self-control, the needs for autonomy, self-evolution and social integration. These are states of tension that can be observed in the framework of emotions, which in turn exert an impact on the hormonal system (Figure 8).

The biopsychosocial stress model (see Figure 8; Henry, 1983; Schröder, 1992) shows that stress triggers increased secretion of adrenocorticotropic hormone (ACTH), cortisol and catecholamines, thereby triggering depression, helplessness and threat status. This oscillation between threat (catecholamine-triggered) and helplessness (ACTH-triggered), between hope and resignation (Sisyphus syndrome) is typical of pandemic circumstances. The autoregulative effects of pandemics on the hormonal system in connection with psychological defence mechanisms can be shown based on similar stressful situations. In one of the few studies during the terrorist attacks of 2001, Stueck and colleagues (2005) demonstrated that the stress hormones cortisol and adrenaline increased during the immediate confrontation with the terrorist attacks of September 11, 2001, whereby the information was warded off by the conscious mind. Since we are dealing with a social isolation situation in the pandemic situation with problematic emotions, it can be assumed that social isolation in the pandemic restriction phase can impair the immune system as a biological basis of our identity, as previously shown (Schedlowski, 1994). The biological ‘core activities’, the so called biological biocentric circle 1, spread into the basic variables of the psyche: behaviour, emotions, cognitions (so called psychological Biocentric Identity Circle 2; Stueck, 2021, see Figure 4, field 18) and influence the process of identity. The optimal functioning of the biological Biocentric Identity Circle 1 (genetic potential, central nervous system, immune and hormonal system) and the psychological Biocentric Identity Circle 2 (instincts, needs, emotions, motives, aims) are internally and externally stimulated by the biocentric fields of actions (see Figure 2, fields 19 a-f) and are the basics for health in pandemics.

BIOCENTRIC CORE AND IDENTITY IN PANDEMICS

The described biological genesis of identity in the biocentric core is accompanied by a psychological identity process which, mediated by emotions, cognitive processes and behaviours, consists of three processes taking place during pandemics in the background:

a) The pulsation between identity (myself) and identification (imitation): Because of this pulsing between identity and identification two processes are constantly running in the background: the internally oriented self-reflection and the self-creation (see Figure 9). In order to shape their own identity, individuals need identification with external models (Petzold, 2012). The external models are largely omitted in pandemics, as public life is very much restricted in the restriction phase and familiar stimuli from the environment are no longer applicable or have changed. In pandemics the person is left to themselves, whereby unpleasant emotions can be intensified. Self-creation leads to a self-organizing development and realization of inherent potential and self-actualization (Rogers, 1959; Braun, 1983; Becker, 1989). For this reason, people who develop internal self-reflection as opposed to external perception and creativity are protected from pandemic stress and its psychological consequences, despite the aroused emotional state (see chapter Biocentric fields of action and biocentric health management in pandemics).

b) The pulsation between individuality (I, ego) and verbal and non-verbal, social cohesion (we, social group) (see Figure 9): These two process levels (a, b), whose ‘pulsation’ on both levels is limited by pandemics, are embedded in the biocentric core (Figure 9). An identity crisis arises when this pulsation is not possible due to external conditions (e.g. restrictions).

As the study accompanying the Pandemic Management Theory shows, self-reflection and self-creation (self-actualization, see aspect “a”) work for those who can maintain an internally oriented perception. In the accompanying study, an increased internal orientation of perception was visible in 70% of the test subjects in Germany (n = 403). Inner orientation correlates significant with autonomy and the ability to overcome emotional dependency. This is a good coping strategy, since the autonomy is limited by the restrictions in the pandemic situation, but can be maintained or compensated for by internally oriented self-reflection (feeling perception, acceptance of what is observed).

c) Instincts and identity: As shown in Figure 9, the main psychic components (motivation, emotion, cognition, BIC 1) are surrounding the biological biocentric core activities (BIC 2) with their consciously and unconsciously occurring activities that mutually influence each other at the biopsychological level. The motivational factors of behaviour that are positioned around the core include drives, instincts, needs, emotions, motives and aims (BIC 2). Instincts are behavioural dispositions that connect people with life, e.g. the fight and flight instinct or the survival instinct. The survival instinct is very important for pandemics since one faces a threat to life through the risk of infection or one’s own illness. The signals of life, the instincts, are threatened in pandemic periods, but also because of dissociations in the culture we live in with a high importance of rational processes in societies which are based on profit-making, exploitation of resources, suppression of sexuality, and dissociations in many other forms. That is why the relation with death in modern societies is so problematic and presents one of the sources of anxiety and compensating behaviour in pandemic or human-made catastrophic circumstances. Studies on mortality salience (awareness of one’s own mortality) in the framework of the Terror Management Theory (Greenberg, 2012; Kemper & Lazarus, 1992) have shown that fear of death switches off the survival instinct in favour of a mental defence strategy (Becker, 1997). One of the thesis of the Pandemic Management Theory is therefore that the identity of people is threatened by more fears than only a fear of death – fear of getting infected and ill or the fear of losing autonomy, which has an impact on self-esteem and cultural values as well as on physical experience and thus ultimately on hormonal and central nervous processes and the stability of the immune system in the biocentric core (Goldenberg et al., 2000). Goldenberg et al. (2000) demonstrated that mortality rates increase the tendency to distance oneself from one’s own physicality (lively corporeality). In addition, after becoming aware of one’s own mortality, a view on humans which emphasizes the differences to animals is preferred (Tichy, 2013). Here it becomes clear that the access to instincts and the emotions they indicate are disturbed. Through the biocentric fields of action described in chapter Biocentric fields of action and biocentric health management in pandemics this access can be restored.

BODY CONTACT AND IDENTITY IN PANDEMICS

The second level of the identity processes (aspect “b”) running in the biocentric core is about the pulsation between the individuality (the ‘I’) and the verbal and non-verbal encounter with the other as well as the physical contact associated with it (social cohesion, the ‘we’). Pandemics support separations of connections (dissociations) on all levels (e.g. between immune system, hormonal system and CNS, between instincts and behaviour, motor activity and sympathetic arousal, desire for connection and physical separation). In the study, 66% said they wanted to be hugged and 29% missed eye contact. The field of vision, which is restricted by wearing masks, also has an important function for emotion recognition, empathy and emotional regulation (Adolphs et al., 1996; Rymarczyk et al., 2019). Touch can be seen as a basic existential need (Wagener, 2000). Davis (1994) summarizes four main areas of meaning of touch:

It becomes clear how important the requirement to maintain contact in the biocentric core is. The effects of physical contact are shown in Table 5.

BIOCENTRIC LIMITS IN PANDEMIC SITUATIONS

A pandemic is a situation of separation, which is why the stimulation of integration of the elements of the biocentric identity circles by activating the biocentric fields of action (see chapter Biocentric fields of action and biocentric health management in pandemics) is so important. The separation between the elements of the biocentric identity circles (see Figure 9) happens because of anxieties and fears, physiological protection mechanisms, body and social dissociations (biocentric limits). The ten most frequently mentioned fears in the accompanying study on the Pandemic Management Theory in Germany (n = 403) were: fear of losing autonomy (70%), fear of getting sick (70%), fear of losing energy (66%), fear of the future (64%), the fear of entering into a relationship with others (59%), of setting limits (56%) and of aggression by others (56%). The fear of death was visible in 30% of the cases. Although touch plays an essential role in our lives and is significantly involved in mental and physical health, it is also closely related to the triggering of fears (Davis, 1994). In the study of the Pandemic Management Theory 55% of the 403 subjects stated anxieties of being touched by others (55%) and touching others (52%) or taking part in group activities (50%). As a conclusion it can be stated that where the pandemic situations trigger fears, so-called fear boundaries become visible, which prevent a connection between the biocentric core and the external life processes. Toro (2011) defined 90 anxieties in four fear boundaries and formulated the request to face these fears in order to stay in contact with life:

In the Terror Management Theory based on Greenberg (2012) it is assumed that fears influence people’s self-worth and value system. For Greenberg it was mainly the fear of death that was active during terrorist attacks. In the Pandemic Management Theory, we assume much more fears (see above) that have an influence on the fact that self-worth, as an evaluative part of the self-concept of identity, is destabilized or reinforced and the value structure shifts. Behind these fears is the trait anxiety, as a personality trait (trait characteristic of situational anxiety). It has an influence on the assessment processes in phase 1 (see chapter The seven phases of the external circle of the Pandemic Management Theory) of the pandemic situations that are responsible for the development of fears. In particular, the fearfulness correlates with the threat assessment of the pandemic situations. Here four types of fear processing could be identified with the corresponding frequency of occurrence during the first restriction phase (see Table 6 March-April 2020).

The term ‘biocentric limits’ was defined in this Pandemic Management Theory in order to clarify blockages that exist in the ‘biocentric core’ of identity due to limited possibilities for self-creation, autonomy, expansion (self-expression) and social exchange processes. Biocentric limits prevent people from a) adapting homeostatically to life processes in the outside world or b) from venturing into the zone of the next development by means of an ‘autopoietic leap’ (see Figure 4, field 9). The following biocentric limits can be assumed and can be overcome by the activities in biocentric action-fields (see Figure 10):

Figure 10

Biocentric fields of action and biocentric borders

The biocentric limits have an impact on a person’s attitude to life (liveliness and vitality), well-being and mental and physical health. Consequences of these abnormal sensations are susceptibility to infections, depression and hyperactivity. The connection with life is lost (depression, exhaustion with hyposensitivity states), limits can not longer be set (e.g. in work behaviour) and this effects the immune systeme as a biological basic of identity. Attempts are made to get in contact with the outside world through hyperactive behaviour, although e.g. physiological passivity (in the sense of an overload inhibition) might already indicate the withdrawal behaviour (Balzer & Stueck, 2021).

CRITERIA FOR A HEALTHY BIOCENTRIC IDENTITY

The Biocentric Identity Model describes and names methods on how a healthy identity can be maintained in pandemic situations. Table 7 summarizes criteria for a healthy identity (Toro, 2010).

BIOCENTRIC FIELDS OF ACTION AND BIOCENTRIC HEALTH MANAGEMENT IN PANDEMICS

As has been shown, the identity crisis triggered by pandemics threatens the biological and psychological functions in the biocentric core (see chapter The biocentric core of the Pandemic Management Theory), especially a) the malfunction of autoregulation and self-organisation (autopoiesis), b) the connections to instincts (e.g. survival instinct) and emotions as the signals of life and c) existential needs as motivators to connect with life (e.g. need for environmental control, self-control, self-development, social integration). Therefore, the establishment of the connection through the activities in the biocentric fields of action is of great importance in pandemics (see Figure 10).

One important aspect of the biocentric activities is that they take place in group activities whenever possible, to strengthen the affective connection to others. This is especially important in pandemics, with the risk of social isolation included.

The substance and the aim of the biocentric interventions in these six fields are the life itself and the connection with the ‘holiness’ and the ‘enjoyment’ with life. This sanctity of life has been lost in many cultures and the pandemic crisis as an individual and genre-specific identity crisis shows the necessary of gaining this connection again. The methodology for gaining this connection is in all fields mainly the experiential learning at an affective (emotion-based), so called penguin level (Stueck, 2015), rather than an intellectual level (so called polar bear level; Stueck, 2015). Affectivity means developing a feeling-based empathic and ethical and aesthetic rather than moralistic and rational connection to all living beings and elements around (Toro, 2010, 2002; Stueck et al., 2010). The basics of biocentric interventions and education were described by Toro (2004, 2005), who founded the method of Biodanza. Biocentric education teaches the inner basics of how to live as a relationship-oriented and ecological human within a natural and cosmical network (Toro, 2005).

BIOCENTRIC HEALTH MANAGEMENT IN WORKING, EDUCATION, HEALTH RELATED FIELDS FOR ADULTS AND CHILDREN

There are many possibilities to work with biocentric interventions. The following criteria describe a biocentric intervention:

When it works with experiential learning in groups by doing and experiencing with all senses and affective contact.

When the feedback after the experience is not asking for an analysis, just for expression of feelings by words, art, poetry, the expression is a “sacred” space. When it asks for feelings (what do you feel about), rather than thinking (what do you think about).

When the method works to secure and develop the aspects of healthy identity (see Table 7).

When I work with materials and sounds from nature (e.g. water, sound of wood, voice, singing) or real sounds from musical instruments.

When the feedback leads to self-reflexion, which doesn’t get evaluated.

When I get support in crisis or insecurities, and the time to make experiences.

When the exercises in the method strengthen the empathy in the group and are not focused on a single person (perspective of the other).

When the focus of the intervention is on support, not about “what is wrong with you”.

When it includes the body orientation, balance between the body-head-way (polar bear) and the head-body-way (penguin) mind in the intervention (see Figure 10).

When the method integrates all aspects of life in the group (all religions, men and women together, inclusion of disabled persons, all ages, animals, e.g. dogs, plants).

When the method is oriented in the “here and now” and is not focused to fast on solutions.

Table 8 shows the levels of interventions related to the biocentric fields of actions.

EVALUATION OF THE PANDEMIC MANAGEMENT THEORY

The theory was evaluated as a part of a study initiated by the DPFA Academy for Work & Health in Leipzig, Germany by inviting nine universities worldwide (see Table 9).

The German test sample includes a total of 400 test persons (150 men and 250 women) who had completed the long form of the questionnaire. In Germany, the study began on March 27, 2020, i.e. seven days after the start of the restrictions (March 21, 2020), and lasted until today with effect and process evaluation. The research instrument used for this, the Health Cube questionnaire (Stueck, 2019) for psychological risk assessment during the COVID-19 crisis, analyses on six levels of analysis the situation (level 1), biopsychological factors (level 2), biocentric and psychological resources (levels 3, 4, 5), as well as behavioural and conditional preventive interventions for coping (level 6). A process questionnaire (Form A, B, C) was then sent out at intervals of seven to ten days. Form D was sent to the subjects 20 days apart further forms were given until today. The results of the studies were published in several publications up to now (Bidzan et al., 2020; Bidzan-Bluma et al., 2020). Since 2020 there is research topic in Frontiers of Psychology (Biocentric sustainable development and COVID-19).