Therapy Solutions for Trauma From COVID-19 and Racial Injustice
The COVID-19 pandemic has caused an anxious population to feel even more unsettled. With no vaccine in sight, it’s been a protracted state of uncertainty.
If we’ve dared to look at the news, we’ve seen stories of people dying. Shortages of basic supplies for the home. Doctors and nurses without the personal protective equipment they need. The economy faltering. Businesses going under. Unemployment skyrocketing. Shelter-in-place orders being relaxed. Infection rates going back up. We’ve understandably felt distressed about what’s going to happen.
Our own lives have been filled with anxiety, to say the least. Some examples, especially when this thing first started:
We’ve experienced cold symptoms and wondered if we had the virus.
We’ve worried whether our loved ones would catch the virus.
We’ve wondered how we’d survive being stuck at home for so long.
We’ve worried if we’d have enough supplies at home.
We’ve worried if we’d be able to get the food we’re used to eating.
We’ve worried if we’d have access to medical care if we needed it.
We’ve worried about losing our job.
If we lost our job, we’ve worried how we’d pay the bills. Or when that unemployment check would finally come in the mail.
Then came the brutal, senseless killing of George Floyd. We were angered by the stark reminder of racial injustice. We heard the president’s inflammatory, tone-deaf words about shooting protestors. We saw footage of police attacking protestors with tear gas or rubber bullets. Yet even more stuff we felt we couldn’t control. As a result:
We’ve felt angry and unsure what to do with that anger.
We’ve felt powerless to change the longstanding, disturbing pattern of systemic oppression of Black people in this country.
We’ve felt stuck... wanting to express ourselves, but not knowing if it was safe to do so.
The combination of the coronavirus pandemic and systemic racism can be truly stressful and traumatic. Read on to learn how to cope, and online therapy solutions that can help.
Did I experience trauma from the coronavirus pandemic?
Now that the shelter-in-place orders and curfews have been modified, and we’re finally able to venture out a bit, many ask, “Did I just go through trauma?”
A quick answer is, “Yes, depending on the individual.”
“And how can I feel okay? How can I heal from this, and finally feel like myself again?”
That’s exactly what we’ll be exploring in this post.
But first let’s define what trauma really is, in mental health terms.
We usually think of something life-threatening… being in a car accident, being the victim of a crime, fighting in a war, etc. But it goes well beyond that.
Trauma is an upsetting or disturbing event that shatters our expectations of safety, making us feel afraid, helpless, or lacking control over what’s happening. As you can guess, it’s worse when the event is continuous or prolonged. It overwhelms our natural coping response and causes lasting adverse effects. And there’s no objective standard - your subjective emotional experience determines whether it registers in the brain as traumatic.
The makings of a trauma response
How to describe the last few months? Stressful, to say the least. Here’s how it may have primed us for a trauma response.
COVID-19 abruptly ripped us from our regular routines, forcing us into a state of extreme uncertainty. It kept us from the things we usually do to feel okay. Took us away from our friends, deprived us of physical contact, and kept us cooped up. We may have felt isolated, bored, frustrated, or even helpless. And we really wished we had more information.
Since then, each day we’ve had to make quick decisions to stay safe. Like how far away from a stranger to stand, when to put on our mask, what to do when someone walks too closely to us in the grocery store, when to reach for the hand sanitizer or get to a sink. We’ve lived in fear of each other, of surfaces, of places, of the future. All the while, we’ve had no idea when this gnarly episode was going to end.
Then came the knee to the neck. Our outrage that this could still happen in America. Our intense drive to speak out, to protest, to make change. A continued feeling of helplessness.
Experiencing stress from the coronavirus pandemic
To heal trauma, we need a brain-based solution.
Why? Because of the long-term effects of all of this stress.
It’s the brain’s alarm system. When someone without a mask gets within a few feet of us, the amygdala may register that as a potential threat, directing the release of stress hormones (adrenaline and cortisol) as part of our fight-flight-freeze response. Our sympathetic nervous system then quickly prepares us to respond to the danger, with faster breathing, heart rate, and blood pressure.
Combine that with other stressful episodes, and over time the brain goes into “high alert.” Our amygdala becomes conditioned to “sound the alarm” more quickly, even in response to mildly stressful stimuli. Because our stress hormones are being secreted more continuously, after a while they take longer to subside, which can lead to long-term health effects. That’s why interrupting this dynamic is key.
Programming and reprogramming
I know this may all sound like a lot. Fear not, dear reader; the goal of this post is to provide some hope.
You see, we can reprogram the brain to heal the effects of this awful experience. We’ll discuss how.
But first, it’s necessary to understand why the original programming is a problem.
How to deal with delayed triggers from trauma
We all have a healthy ability to process memories, putting them into a personal narrative. Ideally, when an extreme stressor happens, it becomes part of our history, informing us without negatively impacting our sense of self, or how we view others or the world. We still feel fundamental “alright,” and the acute stress goes away.
But a traumatic event overwhelms the brain’s usual ability to integrate the experience into memory. Especially when it’s prolonged and continuous, when our nervous system can’t quickly return to normal.
So everything associated with the traumatic event gets stuck in the right side of the brain (which has no sense of time) in undigested, fragmented form. These “fragments” include whatever we experience during the event… physical sensations, emotions, beliefs (e.g. “I have no control”), images, sounds, smells, etc.
The fragments get stored in memory channels - neural pathways in the brain that are like threads of association. And they’re ingrained more powerfully than ordinary memories, thanks to those stress hormones.
When anything around us even vaguely resembles what we once went through, any of the fragments can get triggered. These days that can happen when someone coughs near us or walks too closely to us. And definitely when we hear a blatantly racist remark or a threat against protestors.
The amygdala registers that as a danger, and we go into our fight-flight-freeze response. It feels like we’re getting hijacked, as if what happened back then is happening again now. Over time we become even more likely to perceive things around us as dangerous or scary. Deep down, we don’t feel safe. We don’t feel in control of our environment. We lack an internal sense of comfort, of feeling “okay.”
Did anything I’ve already been through make the last few months more traumatic?
Remember the early days of the pandemic, when we heard about infection rates and death rates, learned about “social distancing,” worried whether we’d get the virus, and worried about our job? And we certainly remember hearing the tragic news of the murder of George Floyd, and how we felt. For some of us, any of that was the original instance of trauma - the template.
For others, those anxious moments were more painful because of earlier stuff we’ve been through. As California’s Surgeon General explains, as compared to others, those with prior trauma experience more stress in response to the same trigger.
Some themes that may predispose us towards this reaction:
If you’ve ever been discriminated against because of the color of your skin.
If you’ve ever been abused or taken advantage of by someone in the position of authority.
If you’ve ever felt stuck in something.
Example: Being “stuck” in your childhood home, having to deal with an angry, controlling, or emotionally dismissive parent.
If you’ve ever felt uncertain about when a difficult episode would pass.
Example: A bad relationship.
If you’ve ever worried about losing your job.
If you’ve ever struggled financially.
Example: Being unemployed, being under-employed, not being able to afford the stuff you needed.
If you’ve ever been taken away from your routine. Delayed, waiting… and hoping that things would get back to normal.
Example: An illness, an injury, a setback at work, a natural disaster, etc.
If you’ve ever feared you may have caught a disease.
Example: STIs.
If you’ve ever been up most of the night coughing and wondering if you’d ever get to sleep.
If you’ve ever worried about your health or a loved one’s health.
If you’ve ever been separated from the people you love.
If you’ve ever felt not taken care of, unsure about your future, etc.
As you can see, the last few months have created a “perfect storm” of difficult stuff to remind our nervous system of what we once went through.
How do I know if I’ve had a traumatic response?
You may be thinking, “I’m not sure if any of this has been traumatic for me.”
If you’ve experienced the following for less than one month, you may be right… it may have been an acute stress reaction instead.
You’ve had trouble getting to sleep or staying asleep.
You’ve had intrusive thoughts when reminded of the pandemic.
You’ve had difficulty concentrating.
You’ve felt emotionally numb.
You’ve felt out-of-body or detached from reality.
But if the above symptoms have lasted for more than a month, or if any of the following have also been in the mix, it was more likely a trauma response.
Your fear or anger have felt outsized.
You’ve found yourself checking the news frequently, as if obsessed with what’s going on.
You’ve felt unusually irritable, or have had mood swings.
You’ve felt amped up, on edge, even panicky.
You’re more achy or fatigued than usual.
You’ve withdrawn from the people you care about (beyond “social distancing”).
You’ve had lots of negative thoughts (especially black-and-white thinking or catastrophizing).
You’ve over-relied on substances to soothe yourself.
You’ve experienced sexual dysfunction.
You’ve neglected your basic needs.
Believe it or not, there’s more. A trauma response can include the stuff in the two bulleted lists above. It can also include symptoms of post-traumatic stress disorder (PTSD). Some examples:
You’ve relived the traumatic event through nightmares, flashbacks, or constant reminders of it.
You’ve avoided things that remind you of the traumatic event.
You’ve stayed away from relationships (beyond “social distancing”).
You’ve felt detached from other people and from emotions.
You’ve had trouble trusting people.
You’ve been on constant alert for signs of potential danger, easily startled.
You’ve been more quick to anger.
You’ve struggled with basic tasks like work or school.
Lots of symptoms… I know. Remember that we all react to trauma differently… that’s why it’s so varied. There’s no right or wrong way to respond to a traumatic event.
How to feel safer and less anxious during COVID-19
Do some quick googling, and you’ll find super-helpful articles on ways to cope, such as this and this. Rather than duplicating them, here we’ll explore brain-based solutions for healing a trauma response.
Problem: A trauma response is more likely when we lack a feeling of control over our environment.
Solution: Create neural pathways associated with your ability to control your environment.
This is called resource tapping. It may seem a little weird, but it works. You can actually give yourself the feeling that you’ve been missing.
How to do it: Think of an aspect of your life in which your efforts are working. It may be a friendship or relationship that’s getting stronger because you’ve paid attention to it. A positive performance review or a promotion. Your helpful efforts in flattening the curve. Or your voice powerfully joining others in protest. Close your eyes, and focus on how you’re the one who’s made this happen. Notice how that feels inside, that your efforts led to positive results. Then do the “butterfly hug,” where you cross your arms and use your hands to tap one shoulder and then the other, alternatingly. You can also tap your knees. Allow yourself to keep feeling that sense of control over your environment, and take that in. Keep “tapping that in” for about 30 seconds.
How it works: Tapping provides bilateral stimulation, which creates or reinforces neural pathways in the brain that are associated with feelings or qualities. The goal is to give your brain the experience of what you need more of but were lacking during these challenging times. The brain doesn’t care where the feeling or quality comes from; it just craves its experience of it.
Solution: Access someone else’s sense of control.
Instead of thinking of your own ability to control what’s around you, think of someone who you associate with that quality, and then “tap that in.” It can be someone you’ve never met, or even a fictional character. Pick your favorite action hero. Or a public figure who’s speaking out against bigotry. Or think of one of those racist statues finally being toppled.
Problem: We make a trauma response more likely by “performing.” In other words, we dive into our work, we pretend everything is fine, we operate as if things are normal. All the while, we’re bottling up the natural feelings that a global pandemic brings.
Solution: Tap in a wise figure.
Identify someone in your life who’s given you guidance or good advice. It can also be someone you associate with that, even if you’ve never met them. Imagine sitting with that person and asking them how you should cope, and what to do with your emotions. As you take in the sage advice, tap that in.
Problem: We’re stressed about COVID throughout the day, with a ramped-up feeling (faster heart rate, more rapid breathing, etc.).
Solution: Tap in a safe place.
If you’ve ever been to therapy before, this is the granddaddy of them all. Identify somewhere you’ve been (or somewhere you can imagine) where everything is peaceful and calm. Where anything stressful seems far away. Notice how it feels inside when you place yourself there, in your mind. Tap that in.
Problem: We’ve been deprived of the things that help us feel okay, feel connected.
Solution: Tap in the things that nurture you.
Yes, we should be relying on things that make us feel good. You know that already. But you can perpetuate that feeling by imagining yourself doing whatever it is, noticing how it feels, and tapping that in. Some suggestions: taking the dog for a walk, eating your favorite food, watching your favorite show, hearing your favorite song, walking or running along your favorite path, etc.
Solution: Tap in your connection to the people you cherish.
They might be right in front of you, or they might be far away. But you appreciate them. Think of a time when you shared a laugh with them. When you smiled together. When you sensed how they feel about you. And then tap that in.
Problem: Expecting the worst actually heightens our risk of PTSD.
Solution: Tap in your resilience.
Tap in a time when your resilience helped you get through something. A variation is to tap into someone else’s resilience.
Resource tapping is safe to try at home. But if you’ve been feeling anxious or overwhelmed for a while, or if you identify with some of the symptoms in those three bulleted lists above, you might consider working with a trauma therapist. I am a Certified EMDR Therapist and regularly integrate resource tapping into my work with clients, both in-person and online.
Together we can figure out what you’re needing, what neural pathways need to be created or strengthened, and optimize the process. From that point forward, whether it’s control, safety, connection, or something else that you’ve been needing to feel, your brain has greater access to it.
What is EMDR therapy and how it can help
EMDR therapy is a leading form of trauma therapy, endorsed as effective by the American Psychiatric Association, the World Health Organization, and the U.S. Department of Health and Human Services.
Together we can get to the source of the anxiety, the sleepless nights, the amped-up feeling, the numbness, the catastrophizing. And then, with EMDR we can heal the harmful psychological effects of stuff that's happened.
The goal is to improve your ability to function on a day-to-day basis, without the emotional pain of what you’ve been through… the ever-present worries about your health, your family’s health, your job. The isolation and the stress of being quarantined. The perpetual uncertainty about how life is going to be. The understandable rage after such a brutal, senseless killing. The understandable outrage over this country’s ugly history of racism and bigotry.
Remember that everything associated with a traumatic event gets stuck in undigested, fragmented form. EMDR gets these fragments unstuck, in effect “releasing” these experiences so that your brain can process them in a healthy way. You’re then able to create more adaptive neural pathways, as you integrate and constructively make sense of the event, with a cohesive narrative.
This is the “reprogramming” that can bring quicker healing than traditional talk therapy.
EMDR can help replace that powerlessness and uncertainty with an internally felt sense of calm. As a result, deep inside you might find yourself feeling “okay” again, able to function, able to live your life.
For lots more on what EMDR is, the research behind it and how it works, check out my blog post, “15 Common Questions about EMDR Therapy, Answered.”
Coronavirus Therapy Solutions During These Troubled Times
As awful as it’s all been, healing is possible. Learn more about individual therapy solutions and couples therapy solutions during this stressful time.
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Andrew Kushnick is a Certified EMDR therapist in downtown San Francisco. As a former practicing attorney, Andrew’s approach is practical and concrete, using science-based and evidence-based methods. Video appointments are available during afternoons and evenings. To schedule a complimentary 15-minute phone consultation, email andrew@andrewkushnick.com.
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References
Fisher, J. Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation. New York: Routledge, 2017.
Parnell, L. A Therapist’s Guide to EMDR: Tools and Techniques for Successful Treatment. New York: Norton, 2007.
Stickgold R (2002). EMDR: a putative neurobiological mechanism of action. J Clin Psychol. 2002; 58(1), 61‐75.
Van der Kolk, Bessel A. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.