THURSDAy, MARCH 19 , 2020. THE WASHINGTON POST EZ RE C5
BY KAREN HELLERBefore the pandemic, before
“social distancing” and “ flatten-
ing the curve” achieved ubiquity
in our lives, before hand-washing
became an hourly aerobic work-
out, before anxiety took up resi-
dence in so many homes, April
Baker was already there.
“Welcome to the last 10 years
of my life,” says Baker, 38, of
omaha who works for a nonprof-
it. “This is how I live every day.”
Baker suffers from health anxi-
ety disorder, also known as hypo-
chondriasis. obsessive-compul-
sive disorder, or oCD, is its fre-
quent companion. Germs are the
mortal enemy. Tony Shalhoub’s
detective character in “monk,”
with his phobia of unclean sur-
faces and bountiful supply of
sanitary wipes , is the disorder’s
poster child.
B aker’s home is never without
end-times supplies of bleach, hy-
drogen peroxide and the twin set
of germ weaponry in our newly
confined world order, dainty bot-
tles of hand sanitizer and jero-
boams of disinfecting wipes.
In recent weeks, her health
anxiety facebook group, which
she helps administer for a few
hours daily, experienced a 32 per-
cent increase in members (to
more than 7,000) and an 80 per-
cent spike in posts.
Baker’s background is in
health care. She attended nursing
school and worked in psychiatric
facility for a decade. Ye t, “it’s a
constant battle in your mind all
day long, ” she says. “ I became
obsessed with learning about all
these diseases.” She’s been in
therapy for seven years.
Health anxiety disorder is un-
derreported, according to the
Anxiety and Depression Associa-
tion of America, and possibly
affects 12 percent of the nation’s
population. (The group’s annual
conference this week was nixed
due to the coronavirus.) Those
who suffer from the disorder are
usually thought of as hypochon-
driacs or germaphobes.
They are the worried well. The
very w orried well. Some sufferers
worry less about germs, and
more about gut health. or vomit-
ing. or that every symptom is a
sign of cancer — a worst-case
scenario, WebmD-and-panic
view of their health.
People with health anxiety are
undertreated, experts says, with
only a third consulting thera-
pists. They’re the ones who have
already figured out that their
issues are psychological. many
sufferers seek help first in emer-
gency rooms, with internists or
specialists, in search of a physical
diagnosis.
“ In a very nice way, we screen
people. What we do is keep them
out of the office,” says John Stern,
an infectious disease doctor at
Philadelphia’s Pennsylvania Hos-
pital. He tells people with no
troubling symptoms, “You’re just
going to have to trust me. Yo u’re
okay. I can’t m ake your anxiety g o
away, but I can reduce it.”
The current alarm about the
coronavirus could be hard on
oCD sufferers, prompting them
to overdo it even more than
usual. However, some people
with health anxiety may be cop-
ing better during the pandemic
than individuals who aren’t used
to worrying about sneezing and
coughing and handshakes and
other casual physical contact,
says Andrew rosen, who runs t he
Center for Treatment of Anxiety
and mood Disorders in Delray
Beach, fla.
“They’ve been fearful of dying
from contamination for a long
time. for these people, it’s not so
much of a transition from peace
time to wartime. They’ve already
gone to wartime,” h e says, the war
being against germs, doorknobs,
disease, the unknown. “They al-
ready have hypervigilant mecha-
nisms.”
rosen’s practice, with a clini-
cal staff of 13, treats a panoply of
anxiety disorders. In the past five
years, health a nxiety b ecome par-
amount.
“ Know why?” rosen asks. “Dr.
Google.”
for every lump and cough, the
Internet sprouts forth potential
scourge. During the past few
weeks, his practice received a 25
percent surge in first-time calls.
“I tell my f riends, ‘You’re a little
late to the party,’ ” says monica,
41, a property manager in South
florida and one of rosen’s pa-
tients. (for privacy, she asked
that her last name not be used.)
“I’ve been in this quagmire for a
couple of years. I’m the boy in the
bubble.”
monica washed her hands 30
times a day before the coronavi-
rus. Clorox Disinfecting Wipes
are a decorating accent. When
she meets a friend for lunch —
not that she’s meeting friends for
lunch now — monica would first
check the restaurant’s health and
inspection report online. once
seated, she would wash her
hands after touching the menu,
her drink, the silverware, an or-
deal.
“I already perceived the world
as everyone being infected or a
threat,” she says. The rest of us
are merely catching up.
As happens with many people ,whether they suffer from health
anxiety or not, monica became
actually , seriously ill — a tumor
on her adrenal gland, which she
had removed in 2018. Treatment
and prescriptions have compro-
mised her immune system.
“Now I’m a germaphobe who
has reason to be a germaphobe,”
she says.
real illness can be clarifying.
“What happens when a hypo-
chondriacal person actually gets
sick?” asks Timothy Scarella, a
psychiatrist at Beth Israel Dea-
coness medical Center in Boston.
“Their hypochondriacal behav-
iors actually decrease. They tend
to refocus on the actual things
they need to worry about.”
Ashley Smith, a therapist in
Kansas City, mo., treats clients
with health anxiety by directly
confronting the issue and alter-
ing behavior. “The more you act
on your fears, your rituals, com-
pulsions and avoidance, the big-
ger the fears get,” she says. So she
has her clients “touching toilets,
following hand-washing bans,
eating with those dirty h ands,” a ll
in the name of healing. (Not that
such experiments would be wise
right now, during the pandemic.
Definitely keep your home clean.
Definitely wash your hands of-
ten.)
Anecdotal evidence suggests
that the current national obses-
sion with disinfecting and social
distancing comes as a relief to
those who already had those
policies stringently enforced in
their own lives. Los Angeles ther-
apist Ken Goodman, who special-
izes in anxiety and oCD, says the
people he treats are “feeling safer
because everyone is more care-
ful.” only one of his 60 patients
experienced an escalation in re-
cent weeks.
“Everyone is doing what
they’ve already been doing,” he
says.
Anxiety welcomes company.
“It’s less isolating when your
anxiety and fear is being shared
by the world,” says clinical psy-
chologist Ta basom Vahidi, who
practices in Los Angeles.Then again, Vahidi notes that
“being inactive can intensify anx-
iety.” And, of course, there’s the
specter of actually getting infect-
ed by the coronavirus — a very
real possibility in a pandemic.
To m Anderson and his wife,
Cristine, chose to self-quarantine
in Baton rouge for a month,
possibly longer. “I feel existen-
tially threatened in a way I’ve
never felt before,” says Anderson,
who worked in disaster relief
management and volunteered at
Ground Zero after 9/11 and in
New orleans in the wake of
Hurricane Katrina. He suffers
from post-traumatic stress disor-
der.
“ I got nervous back in Decem-
ber. I was really concerned we
weren’t doing anything,” he says.
By “we” he means America.
N ow, he worries about his
health (he’s 62) and that of his
wife (age 72, lung issues). “I get
very exhausted, very emotional
and weepy. my body is vibrating,”
he says. “It’s hard to catch your
breath sometimes, and then it
steamrolls.”
meditation helps. music, too.
They do leave the house. Nature
is a tonic. Nature feels safe, free of
germs, when little else does. “The
mother ship is the car,” Anderson
says. “We’re going to swamps and
birding. Avoiding all crowds.”
rosen, the South florida psy-
chologist, and his colleagues are
consulting patients via faceTime
and Skype.
“ We’ll get out of this, ” rosen
says. “ Look at history. Human
beings adapt. We’re hard-wired
to adapt.”
These days, many people are
adapting by doing as germa-
phobes have always done. rosen
says he’s r eceived a deluge of calls
and emails “from all over the
world, including doctors who are
feeling overstressed and threat-
ened themselves. There’s hardly
anybody who isn’t getting affect-
ed,” he says.
“It’s crazy for me to use the
word crazy but,” rosen says, “it’s
crazy.”
[email protected]This population has long been ready for a pandemic
ROB DOBI FOR THE WASHINGTON POSTBY PETER MARKSThe first sign that things were
going south fast for the American
Shakespeare Center came from
the h igh s chools.
In droves, secondary school
groups — a lifeblood for t he reper-
tory company in Staunton, Va. —
began emailing their cancella-
tions. Next came college and uni-
versity groups, which tended to
book performances in April and
may. A nd then finally the l oyalists,
many of them senior citizens, from
Virginia and surrounding states
who make ASC a destination,
started pulling out, too.
In the two weeks since corona-
virus worries began intensifying
in early march, officials of the
company — producers of four,
four-play “seasons” a year, plus a
national college tour — saw reve-
nue marching toward zero. (Lack-
ing virtually any savings, t he o rga-
nization needs about $50,000 a
week from single and group sales
to sustain productions, meet
mortgage payments for its 300-
seat Blackfriars Playhouse and
pay 70 full- and part-time staff.)
And suddenly, a virus still barely
touching a bucolic slice of the
Shenandoah Valley, just over the
mountains from Charlottesville,
amounted to a potential theatrical
extinction e vent.
“What we said to the board,”
recalled artistic director Ethan
mcSweeny, “was that this is an
existential threat at ASC, with no
meaningful financial cushion
when we turn o ff t he box office.”
mcSweeny’s story is playing o ut
in similar fashion at countless
nonprofit arts companies across
the country — not to mention at
commercial venues and ventures
as well. An explosively popular
moneymaker such as “Hamilton”
is not the rule in America, it is the
radical o ddball. f ew a rts organiza-
tions maintain a substantial rainy-day fund; they exist, as it were,
from audience paycheck to pay-
check. In a bit of bitter irony, the
company — f ounded i n 1988 as the
scrappy S henandoah Shakespeare
Express — had just submitted a
five-year economic plan, calling
for an endowment fund for just
such exigencies a s a pandemic.
Throughout the theater busi-
ness, murmurs and speculation
abound about the Darwinian mo-
ment, and about which groups
might not survive u ntil s omething
like normalcy resumes. When
plays stop, lives don’t, and workersin the arts are as vulnerable as
those in any other field. The coro-
navirus crisis forced American
Shakespeare Center, which draws
80 percent of its audience from
Virginia, to scrap eight produc-
tions, some already on the Black-
friars stage, others in rehearsal.
“much Ado About Nothing”;
“Henry IV,” parts 1 and 2; a world
premiere, “The Defamation of
Cecily L ee,” b ased o n “Cymbeline,”
are among the shows s cratched.
“We’re trying to crash-land the
ASC plane with minimal casual-
ties and the biggest c hance we can
to get it up and running again,”
mcSweeny said.
S taff had to be furloughed for
nine weeks: 18 full-time employ-
ees, according to managing direc-
tor Amy Wratchford, including
the education director, marketing
manager, development associate
and literary manager. four others
will be on half pay — including
mcSweeny and Wratchford — and
hours, and another four will work
10 hours a week, for a quarter of
their regular pay. The actors, 14 in
Staunton and a smaller group on
the r oad, w ere a ll g iven two weeks’
notice but a promise to continue
health coverage and residency in
company apartments for the run
of their contracts. In a city of
25,000 where ASC is a centrifugal
aspect of a lively cultural and culi-nary scene, the s hutdown radiated
instantly through the business
community.
“We have canceled all of our
advertising for the rest of the ‘re-
naissance’ season” — the quartet
of plays in which actors direct
themselves — “ and all of the adver-
tising for the rest of the spring,”
Wratchford said. “We do post-
cards a nd f liers for each s eason; of
course that’s canceled. And we
canceled o ur telemarketing.”
Even so, mcSweeny and
Wratchford and the staff calculat-
ed that they would need $350,000
just to get to a proposed restart of
full operations on may 26 and
return to the stage with “othello”
on June 19. As the scale of the
calamity sank in — and state and
federal officials kept increasing
limits on public gatherings — the
ASC team changed its emergency
plan again and again. Each day it
felt as if there was less to be sal-
vaged. “Sometimes, I was t hinking
of that episode of ‘Game of
Thrones’ where they’re fighting
and moving back and back into
another, smaller part of the keep,”
mcSweeny said.
The goodwill of the company’s
audiences has opened a stage door
of hope. L ike many arts groups, ASC
sent out a plea for ticket holders to
withhold requests for refunds and
take promises of seats at f uture p ro-ductions. one of the company’s
tech-savvy staffers set up a digital
dashboard for Wratchford to moni-
tor refunds in real time: It revealed
that fewer than 15 percent of cus-
tomers wanted their money back.
Calls went out seeking tempo-
rary relief on the mortgage.
Wratchford was on the phone this
week to Staunton’s local and state
political representatives, to lobby
for arts groups to be included in
any financial r elief packages being
discussed. In the space, too, of
several hours after m cSweeny sent
an email blast monday enumerat-
ing the monetary challenge, ASC
received $23,000 from support-
ers, in a mounts f rom $ 5 to $2,500.
“What that s ays to me is t hat we
are incredibly valued, and we are
an important resource for our
community,” mcSweeny s aid, add-
ing that this week, ASC is, like
many companies, p utting t he can-
celed productions on film and, if
union issues can be resolved, of-
fering them to the public.
ASC’s creative family will await
their all-important c ue f or the b ox
office to reopen. Until then, mc-
Sweeny said, daily survival take
center stage. one of the actors
approached him this week to re-
cover tools that the company had
borrowed from him. He needed to
look for w ork as a carpenter.
pe [email protected]After cancellations, Shakespeare theater’s supporters open a stage door of hope
LINDSEY WALTERS/MISCELLANEOUS MEDIA/AMERICAN SHAKESPEARE CENTER
The cast of American Shakespeare Center’s “Much Ado About
nothing,” one of several productions scrapped amid the
coronavirus outbreak.ford suit, a Chanel bag or a
Hublot watch. Yes, designer
clothing can be about one-ups-
manship. It lures consumers into
paying an exorbitant premium to
possess products they do not
need; fancy brands can be a
reflection of insecurity writ large.
But aspirational purchases also
tell a story of striving and achiev-
ing. While it is all well and good
to be privately proud, clothes give
people the opportunity to loudly
brag just by walking into a room
and sometimes a little applause
from the crowd is just what a
person needs.
Without these fashion mo-
ments, we have lost the ability to
easily connect, to say something
— even when we might be too
afraid to actually do something.
We no longer have a ready oppor-
tunity to publicly celebrate our-
selves or to simply enjoy the
pleasure of feeling that we are
doing our part to enliven the
visual landscape. The delight in
wearing a new dress or pair of
shoes is not merely in putting
them on for your personal satis-
faction. It is in taking them out
for public inspection so they can
become another detail in your
story — the one that is constantly
evolving and expanding.
When we ask ourselves: “What
should I wear today?,” we are
asking a much bigger set of
questions. “Who am I?” “What
am I expecting from this day?”
“How do I see my life moving
forward?”
When we can no longer find a
reason to consider our attire —
even just a little bit, even for the
briefest outing, we go silent. And
our story, in all of its nuance,
grandeur and humanity, goes un-
told. So as we isolate ourselves at
home, our clothes can be our pep
talk, an impassioned soliloquy.
As we scurry along the street,
dutiful in our social distancing,
our clothes become glancing
waves — reminders that at some
point we will speak to each other
again.
[email protected]day attire dominates the lives of
most white-collar employees, so
much so that if a garment cannot
be worn to the office, well, it does
not have much value. Who both-
ers to spend much money on play
clothes, after all?
We put on our professional kit
to appeal to potential clients, to
reflect the tenor of our industries
or to impress a boss. We dress to
indicate our skills — the lawyerly
suit, the banker pinstripes, the
tech cashmere hoodie. At the root
of all those choices lies a plea —
See my worth. Along with a full-
throated declaration — I am
valuable.
for anyone who works outside
the home, dressing for the office
— whether that office is a class-
room, an assembly line or an
executive suite — means slipping
into an ensemble that identifies
one’s place in the social order, of
announcing you are participating
in the ebb and flow of a commu-
nity. most work clothes do not
underscore individuality. To the
contrary, work clothes remind us
we are part of something. That
uniform, that badge dangling
from a lanyard, that congressio-
nal pin: They are all reminders of
connectivity.
To work from home and never
take off your pajamas can, at f irst,
feel like a kind of liberation — a
celebration of comfort and a re-
buke to stuffy corporate rules
that demand pantyhose in sum-
mer and a jacket at all times. But
going through an entire day in
loungewear, it is easy to lose
yourself and your sense of pur-
pose and focus. our clothes cre-
ate boundaries. They mark time.
folks who regularly work from
home speak of the need to change
out of their pajamas into some-
thing, anything else to announce
their day has begun. To not feel
like a sloth. To feel ready to face
the world because without the
world, who are you?
When we go out into the com-
munity our clothes allow us to
have our say without ever open-
ing our mouths. We settle into a
coffee shop in our favorite jeans
and message T-shirt, and we can
make a political statement or a
childish joke. We can send up a
rallying cry for black lives or
black girl magic or feminism. A
mAGA hat sparks rage — or
solidarity. We can plead for the
environment o r make the case for
a favored artist or musician.
fashion is a form of communi-
cation that is both intimate and
aloof. Without ever uttering a
word, you stand behind your
message because you are, in fact,
wearing it. Clothing is an elo-
quent form of communication for
the inarticulate. It can also be
used as a costume when one
would prefer to make a show of
taking action rather than rolling
up one’s sleeves and getting on
with it.
Clothes are the spoils of finan-
cial success that we wear on our
back. All that hard work and
sacrifice is made plain in a To mgIVHAn from C1Stuck at home, pajamas
overtake power dressing
JONAS GUSTAVSSON/MCV PHOTO FOR THE
WASHINGTON POSTA fall 2019 piece from Christian
Dior. So far, 2020 fashion is
more of the sweatpants variety.TheMovieDirectoryhasgonedark.
Wewillraisethecurtainagain
assoonaseventswarrant.