Another dimension: COVID-19, The Twilight Zone, and me
Authors: Robert D Friedberg
Journal: The Lancet Psychiatry (2021)

"Doctor, I am here to fix your pipes," the voice rang out from behind the locked front door. I am usually quick to answer…But, you know, it has been a strange year! A familiar twinge of anxiety shook me. "Where's my mask?," I thought, and wondered how I could properly gauge six feet of physical distance. I hesitated, worrying about the plumber's mask and his facility with sanitising surfaces. As I said, it has been a strange year. My initial freeze response was probably because—like most other people in the world—I have been quarantining for the past 14 months with my brilliant wife and two gifted cats. I occasionally timidly yell "Hey, how's it goin'?" to neighbours crossing the street, often feverishly waving to them from my window like Forrest Gump from his shrimp boat. This was now the first close contact with another human in over 1 year. Should I open the door? The ferocious emergence of the pandemic provoked profound uncertainty and much anxiety. I needed to adapt and cope, but I did not immediately know how. How could I understand and manage my level of distress during these strange days? I felt untethered, lost, and confused. I searched for roots to gain more solid footing. In the early stages of the viral pandemic and continuing to the present, I sought comfort from one of my favourite old television shows, the original The Twilight Zone (1959–64), created and hosted by Rod Serling. In addition to my aforementioned wife and cats, the show has been a faithful, engaging, and stimulating companion. For those unfortunate individuals who are unfamiliar with The Twilight Zone, it is a US television drama series in which every episode represents a parable. In the opening narration for season one, Serling explained the focus of the show by telling the viewing audience, "It is the middle ground between light and shadow, between science and superstition, and it lies between the pit of man's fears and the summit of his knowledge. This is the dimension of imagination. It is an area we call the Twilight Zone." This middle ground is filled with ambiguity and doubt, which makes discerning superstition from science challenging. The pandemic left me struggling to rise from the pit of my fears and straining to see the summit of my knowledge. The uncertainty and associated anxieties that accompanied my quarantining during the pandemic ignited my desire for parables. What lessons did I need to learn to help me cope with the unknown? What might The Twilight Zone teach me? How could these lessons improve my clinical care practices, teaching, training, and research? Besides finding emotional sanctuary in the show, I recognised intellectually that many episodes addressed coping with fear as well as the unknown. This was so intriguing that I bought books to read about the series. In a 1964 episode entitled The Fear, Serling explained, "The major ingredient of any recipe for fear is the unknown." As noted by Mark Dawidziak, it is this precise formula that pervades compelling episodes like Nothing in the Dark, Nick of Time, and The Gift. Nothing in the Dark was especially fitting, as the story revolves around an old woman's fear of opening the door. The main character obsessively believes that doing so is an invitation to death (kind of like letting the plumber in the house). Consequently, she is imprisoned in her home shackled with anxiogenic thoughts. In The Gift, a story about fear of the unknown and strangers, the main character exhorts others to "make sure the source of fear is not an illusion." Addiction to superstition and false beliefs is explicitly dealt with in the Nick of Time. In this episode, an apparently rational couple becomes dependent on a fortune telling machine in a small town diner, believing that the predictions the Mystic Seer is spitting out can resolve their distressing uncertainties. In all these stories, the characters are beguiled by their irrational cognitions. I was hooked by the content and how similar their fears were to my own. The series reinforced the long-held personal and professional idea that anxiety, doubt, and uncertainty were not to be avoided. They are natural mechanisms. What is important is not to be imprisoned or paralysed by them. I welcomed the nudge towards better coping. As a result of my reading and watching, my interest and understanding of the role of uncertainty in anxiety disorders expanded. The show propelled me towards developing a study with my research laboratory focusing on the role of intolerance of uncertainty and COVID-related worries. Opening the door to the unknown actually enabled more interesting research teaching, and generated training ideas. During the viral outbreak, all my teaching and training efforts were done virtually. I must confess I had never done that before. Initially, the Zoom experience was overstimulating for me and I became easily distracted by chats, messages that my connection was unstable (which I took as a personal insult), and the organisational demand of arranging breakout rooms. Making technological connections was difficult, but engaging interpersonally via a remote platform seemed even more daunting. Could The Twilight Zone help me with this? Later episodes of the show begin with the iconic lines, "You are about to enter another dimension. A dimension not only of sight and sound but of mind. A journey into a wondrous land of imagination." I needed to take that trip and dip into my creative reserves to leverage sight and sound to engage students and trainees. So I searched Google for costumes and masks to dress for my lectures. I found some 60s costumes, superhero masks, and a 70s disco-era suit to wear. At first, my students seemed to think they were in the Twilight Zone with a professor who liked to play dress up! However, for the most part, we all accessed the lighter parts of ourselves and still invested in the material. I also found myself doing half-day and day-long trainings for clinicians in the community over Zoom. Typically, these groups were much larger than my graduate classes. Holding the attention of a hundred people for a long period of time over Zoom was really stretching my comfort zone. I have never had so many people over to my house and never visited so many homes of others simultaneously. I used music and introductory improvisational theatre exercises as ice-breakers and tools for greater audience engagement. I edited my slides down to their essences and accompanied them with eye-catching Bitmojis. To my delight, the training sessions were a hit. My work entered a new dimension of sight and sound. Closed doors began my pandemic story and I suppose that of many others. Although shut doors might be the first necessary move in responding to a pandemic, they cannot be the ultimate solution. If portals remain closed and impassable, you cannot see the other side. Narrow perspectives dominate. In his 2020 book Everything I need to know I learned from The Twilight Zone, Mark Dawidziak wrote that "the magic started to work on me in all kinds of subtle and overt ways. The magic is one of realization: the awareness that you could open a closed door, wander through it and end up, well anywhere your imagination might take you." Yes, I am a supposed expert in clinical psychology, cognitive behavioural therapy, and paediatric anxiety disorders. But this global pandemic thing threw me. My usually free-flowing cognitive, emotional, and interpersonal resources were occluded. But like an old friend and mentor, Rod Serling opened the gate inviting me to see the other sides of myself and the world. Superstition and science became more distinguishable. I was able to escape from the pit of my fears and recognise the summit of my knowledge.