Trauma and Covid-19

Trauma is our response to deeply distressing events that overwhelm our coping abilities.

The global Covid-19 pandemic has brought about world-wide trauma, through the continuous emotional and physical toll that it takes on us. This applies, whether we have suffered from contracting the illness directly or through indirect effects, such as frontline work, family separation, economic loss, lockdowns, healthcare changes, travel restrictions, media exposure, or future uncertainty. In fact, despite the pandemic not meeting the criteria for trauma disorders, including Post-Traumatic Stress Disorder (PTSD), recent research shows that Covid-19 can trigger PTSD-like symptoms in us (Bridgland et al., 2011).

How does the pandemic do this and how can we protect ourselves?

Danger

Covid-19 threats to our safety are at the heart of trauma experiences. These can be experienced directly as dangers to our own survival and wellbeing, or indirectly as dangers to the people around us. This is augmented by media reports that emphasise risks and deaths, which can make the threat of Covid-19 seem omnipresent even if cases are low in our immediate location.

Notably, safety is not just linked to Covid-19 itself, but also the economic impact it has had globally. We might feel anxious about our job security, despaired at our financial situation, or angry at regulations that make no sense to us but that we suffer under. Given that we rely on money for our most basic needs, such as food and shelter, financial loss can be traumatic by presenting a significant existential threat to our survival. Even if our immediate survival is not in danger, uncertainty or decline in our financial situation can threaten our sense of security. In addition, watching businesses around us struggle and close can make us feel demoralized and hopeless for the future.

It is important to reality check our feelings that arise from the information we consume as well as checking credibility of information sources. Is there imminent danger to our health and survival or that of our loved ones? If yes, what measures can we take to reduce our risk of contracting Covid-19 or supporting ourselves to meet our basic needs? If no, how can we make ourselves feel safer overall to counteract the anxiety triggered by the concept of the pandemic?

It can be helpful to acknowledge feelings that we are experiencing before jumping into action. This can bring clarity by allowing them to arise and be processed, rather than being suppressed and intensifying. Furthermore, it is important to identify the key challenges and explore potential solutions. This can be done is a systematic way and can include creative brainstorming as a way to get our out-of-the-box thinking flowing. Organizing ourselves and actively looking for options can make us feel more in control, which counteracts some uncertainty and boosts our mental health. It is also helpful to reflect on what usually makes us feel safe and protected. The latter may involve token items such as blankets or incense, meditating, or creating a safe space. Connecting with friends to talk things through can also  help us to bring structure into our thoughts, see the problem from new angles, enhance our motivation, and make us feel safer together. Things that have made us feel safe in the past activate the associated brain network, which makes it easier to help us feel safe again in the present.

Uncertainty

An overwhelming trauma trigger of the pandemic is the on-going uncertainty around the development of Covid-19 itself, the global effects, and the future. Will things go back to what we knew as ‘normal’? When will it all be over so we can get on with our lives? Our brains do not like rapid change and unpredictability, which is what has characterised our reality for the last 18 months or so. We get confused, we barely know what the latest regulations are, and we have resorted more and more to throwing our hands in the air.

We have never had immediate control over the macro-context of our lives, such as politics, socio-economics, or the environment, so this is nothing new for us. It has simply been enhanced by the pandemic as changes are more rapid and have greater effects on the daily rhythm of our lives and actions, not allowing our brains to adapt and re-focus on things that are in our control. At times, this can leave us feeling helpless against the forces of greater power.

It is crucial for our mental health to recognize our perceived loss of control and the feelings that come with this. Cognitive reframing can be a helpful tool to move forward and re-establish a sense of control and predictability in our direct environment. This can come in form of setting ourselves a routine to make our day-to-day more predictable or having anchor points in the week in the form of activities that we can look forward to. It is key to remember: we can control our own actions only, not the actions of others or random incidents. While this can feel frustrating, it can also be empowering.

What actions can we take to create the life we want to see in our present?

Disorientation

At the heart of trauma is a loss of the assumptive world, which are our beliefs about the world and its people, that help stabilize and orient us. Three assumptions are essential here:

  1. The world is benevolent
  2. The world is meaningful
  3. The self is worthy

In other words, generally, the world is safe and good things happen, the world is predictable and just, and we are worthy of good things happening to us. Trauma can shatter these assumptions by bringing unexpected, unprovoked, and seemingly random violence, destruction, and death. This can be disorienting for us, making us feel de-stabilized, lost and vulnerable, and forcing us to re-assess our belief system.

The Covid-19 pandemic has triggered such loss of assumptions. At a global scale, the world seems to have been thrown into chaos with no good reason. Things are unpredictable and people are unfairly suffering, and even dying. Instinctively, this may drive us to try and understand where Covid-19 originated, in order to have a reason, a scapegoat or help us find evidence that confirms our assumptive world is still valid. It is substantially more painful to have to come to terms with the fact that random, unfair, terrible things happen and there is nothing we can do to prevent them.

It is crucial for our mental health to find meaning in the pandemic and adjust our assumptive beliefs about the world. Research shows that finding meaning in a collective trauma experience is associated with subsequently fewer trauma symptoms and enhanced overall wellbeing (Updegraff et al., 2008). This is not an easy task when things feel restrictive, dangerous, and meaningless.

The first step is reflecting on the fact that bad things can happen outside of our control and what that means for us. How does Covid-19 affect our unique assumptive world? What past experiences and feelings may be triggered by this? And importantly, how can we make choices that can provide meaning for our traumatic experience? Some people choose to create meaning by helping to reduce suffering for others, for example through emotional or financial support. Others find a silver lining in the circumstances and re-focus on unique opportunities that arise. Again, others turn to faith, identify strength in personal growth, or find greater appreciation in life as a result of tragedy or restrictions. There are many ways we can create meaning from suffering and it is most effective when we do so in ways that feel right for us.

The global Covid-19 pandemic can trigger trauma responses by evoking a sense of danger, uncertainty, and disorientation. We can use protective measures to reduce the impact of these on our mental health. Given the strain of the ongoing Covid-19 situation and the toll it has been taking on our wellbeing, this can be challenging and sometimes additional support can be highly beneficial.

If you have been noticing trauma symptoms as a result of the global pandemic, and wish to speak to a trauma specialist, please get in touch and book your appointment.

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