I’m FEDup with people saying they can’t adjust to wearing masks even though they help protect lives during a pandemic.

If you have access to a mask but won’t wear it, take a #CripTip: Shift your narrative from, “I CAN’T ADJUST!” to “I will adjust and it will take time.”

I get it. Masks feel strange and uncomfortable. But unless you’re one of the relatively few who truly cannot physically tolerate wearing a mask, face shield, or other face covering, it’s not about whether you can. It’s about whether you want to.

Since you presumably want to save lives during a pandemic, the first step is dealing with what you’re telling yourself about wearing a mask and then, as needed, unpacking that typically messy box where emotions and physical feelings are stored in a jumble.

Note: I’m not addressing this to the, “But I shouldn’t HAVE to wear a mask and I won’t!” crowd. I have many skills but Fixing Selfish Magical Thinking isn’t one of them.

I’ve been there: During the second week of April in 1993, I woke up in UCSF Medical Center’s ICU with a mask strapped to my face. I learned in short order that the mask, and the Bi-Pap S/T machine it was connected to, were henceforth to be with me every night, with no exceptions, for life. I was 27.

I had been hospitalized the day before with pneumonia and given the SOP of a nasal canula for oxygen support. All was well until I drifted off and experienced carbon dioxide narcosis caused by undiagnosed sleep apnea and chronic respiratory insufficiency.

I coded three times that night but only remember the first episode. I survived after the medical team eventually realized it was the treatment itself – supplemental oxygen – that was playing the role of Grim Reaper.

Even in the midst of acute illness, with a deep knowledge of managing life with muscular dystrophy, and an intellectual grasp that my life was at stake, I fought the notion of having to wear the mask. So I can imagine someone else’s resistance and empathize with their initial, “It’s just too hard.”

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What Helped: I had a clear, direct, and consistent narrative to push back against: Wearing the mask was necessary, full-stop.

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Emotions and Sensations: Focusing too much on the rational dimension of why wearing a face-mask is necessary ignores the deeper driver of responses to complex medical situations, including the COVID crisis: Feelings. Emotional and physical.

Emotionally, I was overwhelmed by what the Bi-Pap mask represented, the external evidence of my fragility and an ongoing reminder that I’d just come very close to dying. The mask and I met during a medical crisis that abruptly changed who I thought I was, making for an inherently rocky relationship. The mask became my new face as a suddenly-much-more-disabled-person.

That all compounded the simple strangeness of having such a contraption strapped to my face, night after night.

Physically, wearing it was wasn’t hard at first while I was still in the hospital; I was so ill that exhaustion made it a comfort. But a few weeks later, at home, I had complaints as people do about face-masks now. My mask felt weird and wrong. It made feel claustrophobic and disrupted my sleep.

Over the first 18 months or so, I rebelled occasionally and tried to sleep without it, and always got the same crummy result. Minimal, unrefreshing sleep; a gunshot headache in the temples upon waking; and walking into walls the next day out of grogginess. Eventually, I learned, albeit the hard way. Adjustment took time, like it always does.

On the plus side, unlike you when you refuse to wear a mask, I wasn’t hurting anyone but myself.

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What Helped: Differentiating between the – valid – emotional reaction to having a mask strapped to my face and the physical sensations of wearing it. Both were unpleasant but were much easier to cope with when separated.

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You Adjust to Wearing a Mask By Wearing a Mask: When I got the Bi-Pap mask, I had the advantage of a couple of earlier experiences that most people don’t have: At the age of four, I’d had to adjust to wearing a Milwaukee back-brace. When I was 13, I had a full spinal fusion and was in a body-cast for 6 months. Relearning how to sleep was just one example of what I already knew I could do.

This meant I had hard-core training in accepting medical necessity and managing my expectations around what I’d have to become accustomed to. This didn’t make adjusting to wearing a Bi-Pap mask quick or easy. But it made adjustment the inherent goal from the beginning.

I had a crucial, reliable narrative helping me from the outset: That it wasn’t a question of whether I could wear the brace or the body-cast but of how would I get through the rough initial period.

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What Helped: Adjusting to something I didn’t like = Active Doing + Time.

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If You Tell Yourself “I CAN’T ADJUST!”: If you do this, you don’t have a mask problem. You have an unreliable narrative problem. It is going to mess you up, that voice with it’s defeatist narrative of learned helplessness.

You deal with it by consciously interrupting it and thinking, “I will adjust and it will take time.” Don’t go all-caps.  Be cool like a little Fonzie.

I hope it’s clear that I have much empathy for you, Person Who Can Wear a Mask But Won’t. But my patience for you is scarce when your intransigence threatens my survival. Which it does.

So please start to work on making the all-important first adjustment – in your thinking, where that internal narrative is screeching your own unique version of, “I can’t live LIKE THAT!”

 WEAR YOUR MASK!