Reducing Preconditions of Trauma During COVID-19

By Rochelle Honey-Arcement, LMSW, MA, Director of Mobile Crisis Outreach

As we near the one month point into the COVID-19 crisis here in Iowa, it is important to remember our mental health and the impact this crisis is having on those who continue to work in their workplaces, those who are working from home, and those who are newly unemployed. This experience has been traumatic for us, but there are ways to decrease the lasting effects that it may have on our mental health.  

According to Bessel van der Kolk, a pre-eminent trauma researcher, there are seven elements of traumatic situations that greatly increase the likelihood of people developing post-traumatic stress disorder, or PTSD. These elements are called “preconditions for trauma.”  For many people, during this current crisis, some, if not all, of the following elements, or preconditions, may be present: 

• Lack of Predictability
• Immobility
• Loss of Connection
• Numbing Out and Spacing Out
• Loss of Sense of Time and Sequence
• Loss of Safety
• Loss of Sense of Purpose

There are specific things people can do to eliminate these elements or decrease their impact.

Lack of Predictability

When we experience a trauma, we may notice a change to what we perceive as “normal.” What we can expect of others, how we react to situations, and what our day-to- day lives look like can be altered in huge ways. That is certainly what many of us are experiencing during this COVID-19 crisis whether you continue to go to work at your workplace, you have shifted to working from home, or you are no longer working due to being laid off. Our normal way of life has changed and we are adapting to a new normal, without knowing how long this new normal is going to last.

One step you can take to support your mental health is to keep a schedule for your day. Create a new routine, put activities on your calendar, including breaks throughout the day to move around. Include things to look forward to. Do you have a favorite hobby you can still do? Schedule time for that. Are there new things you would like to learn? Schedule time to learn them. Set up video chats with friends or colleagues. Create a calendar of possible connection opportunities. By scheduling these activities, we can create predictability in our lives, even during a situation like the one we are in.

Immobility

During stressful situations, our bodies go into fight or flight reactions. Our bodies react by surging with stress hormones to protect us from a threat. Our bodies cannot tell the difference between an emotional threat and a physical threat like being chased by a saber tooth tiger. Due to generations of our ancestors facing mainly physical threats, our body reacts to the kinds of stress and trauma we are experiencing right now by preparing us to fight for our lives or run away to safety. But running away to safety is not possible right now. We cannot flee our current predicament. That leads to an increased risk of fighting. In small spaces, that can lead to dangerous situations.  

To decrease this risk, we must take action using our bodies.  We can use the energy created by the stress hormones to do things around the house like cleaning, repairs, crafts, exercising—anything physical that will help get the levels of hormones back down to normal.  We can also engage in self-regulation activities. These are activities that help us regulate our emotions when we are experiencing heightened emotional reactions.  Some of these self-regulatory activities include yoga, mindfulness, meditation, and other breathing activities. There are many free resources on YouTube and other sites where you can learn these skills and practice them.  

Learning these self-regulation skills will be beneficial far longer than our current crisis will last.  Having the ability to regulate our emotions will be of benefit in any stressful situation you may find yourself in.

Loss of Connection 

In traumatic situations, we feel isolated from others, as if we are alone in our suffering.  We crave connection with others, to come together to grieve and to care for one another. In previous crises, such as 9/11, we held candle light vigils, we have marched together, we congregated at our places of worship.  Yet we are being asked not to do that right now. We are social beings, even the most introverted of us. We need human connection. We need to connect visually and emotionally with others.  

The last time our country experienced a crisis like this was back in 1918 with the flu epidemic.  At that time, approximately a third of households had telephones, meaning that two thirds of households had no way to communicate with others outside of the home.  Today, many of us have the ability to video chat with people all over the world, making our ability to connect far easier than it was the last time people were forced to social distance.    

The value of video chatting with others is immeasurable.  As humans, much of our communications comes from our non-verbals, from our facial expressions and body language, from the give and take rhythms created through our visual connections with others.  These connections help us to feel alive and connected emotionally. From our very beginnings, our visual connections with our caregivers allowed us to feel safe and to learn how to regulate our own emotions.  Through video chats we can recreate that sense of safety, connect on an emotional level with the people we care about.

Numbing Out and Spacing Out

In traumatic situations, it is normal for people to respond by numbing out or spacing out.  This is a protective reaction and it helps to prevent emotion overload. But if done to excess, it ceases to be helpful and leads to a loss of agency, our sense of control over our own actions and choices.  If you find yourself depending on numbing activities to get through the day, you can prevent long-term consequences by starting to tune into your body and connecting with yourself.

The first step is to notice yourself, how you feel, where you have discomfort.  By doing this, you tune into your body and what it needs. You can begin to identify what emotions you are having and how those emotions show up in your body.  If we don’t notice ourselves, we react automatically out of anger, fear or irritation. When we start to notice ourselves, we can make choices on how we act or react to the situations around us.  

If you are finding it hard to connect with yourself, first, have compassion for yourself and your reactions.  We are not commonly taught these skills. Acknowledge that the feelings you are having, even the anger and fear, are helping you survive this crisis.  Then, reach out to others in your life who can help you notice yourself and name your feelings. Reach out to a counselor if you need additional support.  Counselors are trained to help people notice things that often go unnoticed and to teach people skills for coping.   

Loss of Sense of Time and Sequences 

When we are in traumatic situations, time seems to stop.  It feels like that moment will last forever and that things will never be different from how they are right now.  We lose track of what comes next and the normal sequences of life. Time gets mixed up in our minds. That is why it is often difficult to explain what happened in a traumatic situation in a linear manner.  Our minds stop working in a linear manner.  

Therefore, we need to regain our sense of time, to notice that there are differences in each and every moment.  It is important to note that the world keeps moving and time continues to march along. Nature can be a powerful reminder of the sense of time and sequence.  It continues on its path through the seasons. Outside, things are slowly becoming green again, the birds are singing. Take notice of the changes in nature, marvel at how it does not stop its progress, even as we are experiencing this stressful situation.  

If you are unable to get outside, there are programs you can watch on television and online. The baby eagles have hatched in Decorah, IA and you can watch a video stream of them growing online.  You can even go on virtual tours of our National Parks, a way you can see parts of nature you may never otherwise have the opportunity to see.  

Loss of Safety

Our safety is truly threatened right now, but there are things each of us can do to increase our safety.  Certainly, follow the public health guidelines right now. Social distancing, washing hands and surfaces, wearing masks when out in public and around others – all of those things are helpful for the safety of you and everyone else.  But there is more that we can do to help us feel safe.

Identify what makes you feel safe.  Do certain smells, fabrics or items make you feel safer?  Maybe have pictures out of your loved ones or of places you have felt safe. Whatever it is that makes you feel safe, try to recreate that sense for yourself.  

Designate a space where you can go and not be disturbed.  We all need privacy. This can be created, even in small spaces.  Communicate with those around you about your needs for privacy. Respect each other’s needs for privacy.  We are all feeling stress and each of us reacts and copes with stress differently. Be patient with others and yourself with your attempts to cope with the current situation.  

Finally, we may not always choose the most healthy ways to cope.  If you see yourself slipping into unhealthy patterns or your methods for coping are not easing your distress, reach out for help.  Help is out there. The counselors on both mobile crisis and our crisis line/chat/text can help you with referrals to appropriate help if you need it.  

Loss of Sense of Purpose 

We all need a purpose, a sense of who we are and why we are here.  In our current situation, whether you are working from home, have been laid off, or continue to go to work but have experienced significant workplace change and stress, we may not feel as connected to our purpose.  We may not be engaging in activities that give us a sense of who we are. For those on the front lines working with those who are sick, there can be a sense of helplessness from watching people suffer from this illness.  

Remember that you are not defined by your job.  What brings you joy or energizes you? Find activities that affirm who you are and what you are passionate about.  Engage with people who have a similar purpose in life. You can find groups interested in all sorts of things online.  Find ways, however small, to make a difference in the life of someone else. Sometimes it is the littlest thing that can bring joy to someone else, and doing for others brings joy to your life as well.  

Remember, when interacting with others, that we are all in a stressful, traumatic time, and we need to be mindful of how we are interacting with one another.  Have patience, be respectful, be kind and generous, and listen. We often forget the power of listening and just being there for one another. We tend to want to fix the other person’s problem, but sometimes there is nothing that can be, or needs to be, fixed. Our power lies in our ability to hold space for the other person and listen whole-heartedly. 

We are all in this together, even if we cannot be physically together.

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