Post-covid trauma: what can be done?

In 2020, the world was thrust head-first into a two year battle with an unknown, dangerous virus that killed 6.28 million people. Beyond the physical threat, it also caused disruption to the way people live, work and connect. In particular, the work-from-home adjustments and the disconnectedness from those we love was an unparalleled change. And for a long time, it felt like it would possibly be this way forever.?

Going through this is what many professionals would register as traumatic.

What is trauma?

According to the American Psychological Association (APA), trauma is “an emotional response to a terrible event like an accident, rape, or natural disaster.”

However, a person may experience trauma as a response to any event they find physically or emotionally threatening or harmful, in this case - a prolonged period of uncertainty, disruption to normal life, and disconnection from people.

"Trauma is a psychic wound that hardens you psychologically that then interferes with your ability to grow and develop. It pains you and now you’re acting out of pain. It induces fear and now you’re acting out of fear. Trauma is not what happens to you, it’s what happens inside you as a result of what happened to you. Trauma is that scarring that makes you less flexible, more rigid, less feeling and more defended." Dr Gabor Mate

A traumatized person can feel a range of emotions both immediately after the event and in the long term. They may feel overwhelmed, helpless, shocked, or have difficulty processing their experiences. There are also possible long-term effects and in certain situations, trauma can also develop into a mental health condition known as post-traumatic stress disorder (PTSD).

Indeed, according to Dr. Difede, attending psychologist at NewYork-Presbyterian/Weill Cornell Medical Center, the nature of the pandemic has been an invisible threat that has been going on for a long time:

“Often, a person’s threat is clear to them and they are faced with a choice of what to do, but since the threat of COVID-19 is invisible and society has been facing that threat for so long, your body is constantly preparing to fight, flee, or freeze, perceiving danger literally everywhere,”        

How has this trauma affected us?

All periods of transition cause stress and require mental shifts and adjustment. Certain amounts can even be healthy for our growth and contribute to strengthening our resolve. But with covid-19 it was at quite a different level. Any form of stability was gone, we were left very much on shaky ground.?

These certainties and regular patterns that we had taken for granted - like how to go to work, where to eat lunch, the colleagues we chat with were all removed - at a very rapid pace. Studies have shown that even routine certainties activate the reward networks in our brain, and without these, we would naturally be affected.

"The absence of reliable patterns means it literally hurts when we’re not able to think more than a few days ahead." David Rock

Trauma, if not dealt with properly, can cause people to act in numerous unhealthy ways e.g. severe aggression and acting out. Addiction to substances, withdrawing from others, or even spiralling into depression might be some ways in which people try coping with the trauma.

“We’re just not meant to live under this level of tension for such a prolonged period,” said Vaile Wright, senior director of health care innovation for the American Psychological Association. “So what that ends up doing is it really wears on our coping abilities to the point where we aren’t able to regulate our emotions as well as we could before.”

Furthermore, when people have experienced a sustained period of stress, they tend to break down once there is a moment of calm or break. This is something that could possibly happen once “normalcy” resumes, or even on an individual basis when they catch a breather.

Being prepared for the post-covid psychological impact

So even as the world begins to open up and the physical threat decreases, we should be very aware that the emotional and psychological impact is possibly here to stay, and for quite awhile. In fact, it may only just be beginning.

The pandemic hasn’t been a one-off disaster but “a slow, recurrent onslaught of worsening things,” adds Tamar Rodney, from the Johns Hopkins University School of Nursing, who studies trauma. “We can’t expect people to go through that and for everyone to come out the other side being fine. People suffered in between, and those effects must be addressed, even if we’re walking around maskless.”

In fact, various mental health issues have already been heightened by the pandemic period - with anxiety, depression and social isolation becoming more of a concern, to name a few.?

The good news is that there has already been greater awareness of the importance of supporting people who are struggling, but yet, more must still be done.

It is imperative that individuals and communities prepare themselves for this way forward, and find solutions to the various issues that will be present in the post pandemic age.

How we can find ways to recover and heal?

1.Encouraging Connectedness…

Social isolation was brought to the forefront during the pandemic, with key groups affected - for example, the elderly and adolescents. Creative ways should be sought to engage with these groups and keep them mentally and emotionally healthy.?

Adolescents were also a group that caused concern, being disconnected from their friends and experiencing increasing levels of anxiety, while navigating the complicated online word.?They also had disrupted school routines, without community events to bring the together.

As the pandemic wanes, Ginsburg, who is also author of Building Resilience in Children and Teens: Giving Kids Roots and Wings, says there’s a real opportunity for families and communities to better support teens’ emotional well-being.

“I hope things don’t go back to the way they were before the pandemic. Every generation is shaped by what it’s exposed to during adolescence, and this generation has been exposed to an understanding that human beings need each other. This could be the greatest generation ever if they are shaped by this essential truth.” Ginsburg        

2. Acknowledgement and de-stigmatization of trauma

There’s power in labelling - be it the lessons learnt, or even the stress that one is feeling. Studies show that putting words on difficult emotions helps dampen them, because labelling puts distance between our experience and the sensation.

People should be encouraged to express the difficult emotions they may feel - grief for pre-pandemic life, or even struggles in the workplace. There may not be an immediate solution yet, but it is helpful to create safe spaces for this articulation.?

When people are grieving or just taking a longer time to deal with multiple changes, we could exercise understanding and empathy. Instead of rushing them towards an endpoint e.g. "Just let it go, it's over." we could offer compassion and say, "It's ok if you need to go slow today. Let's take it one step at a time."

One thing to note is that acknowledging your feelings is not weakness or "giving up". Instead it is recognising that your feelings exist and have an impact on you, and the willingness to reflect or allow those emotions without judgement is far healthier than just brushing it away.

3. Rebuilding / Re-emphasising of structure

As structures are being put back into place whether at the workplace or at home, one should once again expect some difficulty in this adjustment. Here are some tips that can be helpful:

• Take small steps. As above, taking big steps may seem daunting, so it could just be just doing that one small thing that day e.g. saying "hi" to a colleague whom you've only met virtually, as opposed to going out for lunch.
• Remind yourself about the usefulness and “why” behind different routines. You may find it frustrating to have to readjust again and constantly be asking "Why?". When you find yourself stuck in this mode, take a deep breath and remind yourself about the usefulness of structure and routine in helping you readjust. For example, waking in the morning and taking a slow walk to the bus stop before heading to work can help you feel centred prior to starting your work day.
• Allow for setbacks. Instead of perfection, we can focus on progress. There is no one perfect way to do things or navigate when things change frequently. Instead, remind yourself that you are making progress, one day at a time. And if you do make mistakes, it's not just you. So many people are in the same boat, just like you.

4. Being direct about what you want and need

It is still a very tentative “new normal”, and clear communication about what you might need to readjust to this is important. Be it comfort level regarding physical gatherings, or the need for professional help, being direct is essential in this time where we are all moving on uncertain ground.?

It might help if you write down your thoughts ahead of time, before you head into any conversation that potentially seems difficult or challenging. That way you will have much needed clarity and feel more prepared. Check out my article on handling difficult conversations.

5. Seek help

After reading all the above, you might find yourself in the position when you need extra support or professional care. It is no shame to seek help and in fact, it can be just the thing you need. A trained professional will be able to offer support and perspective that your family/friends cannot.

Remember, there is no need to suffer alone or think that you need to be strong through all of this. After all, we all respond to challenges in very different ways. Seeking help simply means that you will be able to lean on someone who has the tools and resources to support you to feel better. Here are some resources for you (if you're based in Singapore).

Conclusion

This may be the first time you acknowledge to yourself that covid has been a traumatic event. Some of us lost people we love, jobs that we thought we'd stay in for life, concept of what is "normal" and so much more. Acknowledging is the first step to healing - and being able to know what the next steps might be.

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Disclaimer:

I share authentically what I think possible solutions might be, but it is purely from what I have studied (scientific evidence) and my own experience in coaching & training others in this area for the past 11 years. I am not here to diagnose or treat. If you need further help, please do seek the necessary support.

References:

https://drgabormate.com/about/

https://www.theatlantic.com/health/archive/2021/05/pandemic-trauma-summer/618934/

https://hbr.org/2022/02/we-need-time-to-rehabilitate-from-the-trauma-of-the-pandemic?registration=success