COVID 19, Doctors and Nurses, and the Effects of Complex Trauma.

When we think of traumatic stress, we typically imagine the
soldier who experiences the horrors of war, the child who is abused, or someone
who witnesses a horrible accident. But there is a lesser-understood type of traumatic
stress. It’s called Complex Trauma (CT), and its impact can be just as
harmful. 

One of the ways CT can occur is when an individual or group experiences
persisting trauma or feels trapped in a high-stress situation over an extended period
of time. Essentially, the elements of CT are a sustained existential threat coupled
with feelings of helplessness and no end in sight.

Years ago, a group of American physicians and nurses volunteered to travel overseas to treat Syrian war refugees. These medical heroes threw the full weight of their knowledge and expertise against that crisis. They labored for months, but the suffering kept coming. Eventually, they were forced to come home as the tragedy continued to unfold behind them.

I recently spoke with one of those volunteer doctors. He
explained how the experience had impacted him psychologically. “I experienced all
of that years ago, but there isn’t a day that goes by that I don’t think about
those people. I’ll just be sitting there, and the images will pop into my head.
It happens all the time. I don’t think I’ll ever let it go.”

The human mind has evolved ways to survive trauma. To cope,
that doctor’s emotions had been put on a shelf so he could persevere. His
thought, feeling, behavior sequences had been abruptly altered so he could rise
to the occasion. And he paid a price.

Everyone experiences trauma differently. What traumatizes
one person has little or no effect on the next. Many healthcare workers will work
through the COVID 19 crisis and be none the worse for wear. Some will be mildly
or moderately affected, and others will be heavily impacted.

If you’re a healthcare professional working on the frontlines of the coronavirus crisis, here is a list of practical action items you can use to avoid future post-traumatic-stress issues:

• Attend to the Basics:
  • Sleep as best you can.
  • Make sure that you’re eating good food and enough of it.
  • Exercise whenever you can. Try to get your heart rate up every day, and if you can do so in the sunshine and fresh air, all the better.
  • Find ways to checkout. Hot baths. Long walks. Allow yourself to sit and stare out the window or to daydream. Allow yourself to get lost in a good book or your favorite HBO or Netflix series, and so on.
  • Mindfulness meditation is golden. Giving your brain even 15 minutes downtime a day can increase resilience tremendously.
  • Speculate about some exciting things you’ll do after the crisis is over, a trip you’ll take or time you’ll spend recreating once your communities are crisis free.

• Know It, Name It, Tame It:
  • Be aware if you are working in a CT situation. Simply
    having consciousness about what you’re up against and naming it helps your
    brain and body cope.
  • Healthcare workers, especially physicians, are
    often used to a high degree of mastery over their environments. Know that the COVID
    19 pandemic is a very complex and sometimes chaotic event. Cause and effect
    will not necessarily repeat, there will be many agents of influence, and
    rational intention might not serve as well as it usually does. You may have the
    feelings of sustained helplessness associated with complex or chaotic circumstances.

• Keep the Emotional Energies Running:
  • “What is a shower? A shower is where men go to
    cry.” That’s what we used to say back when I was a therapist. Sadly, the spirit
    of this saying applies to women, as well. Many doctors, regardless of gender,
    feel pressured to neglect their own needs—especially emotional needs—in the
    name of attending to others. Doctor, heal thyself. If you feel grief, sadness,
    or overwhelm, crying can prevent the emotional energies from stopping up.
    Generally, crying is good.
  • Know that there’s nothing wrong with you if you
    are afraid.
  • Know that there’s nothing wrong with you if you
    are angry.

• Talk About It.
  • I’m sure there are people out there who don’t
    need other people, but I haven’t met one of them yet. Make sure you’re talking to
    someone about what you’re experiencing. Friends or family members can often serve
    this purpose.
  • Your friends might care about you too much and
    get worried or frightened, or maybe you’re the axis mundi of the family
    and it threatens your spouse when you talk about your feelings. When friends
    and family members can’t be neutral about what you’re going through, use a
    therapist. If a therapist isn’t right
    for you or if you fear a medical record or DSM diagnosis, contact a clergy
    member or coach.

Hopefully, social distancing and suspensions of gathering will
slow the spread of COVID 19 until we find an effective treatment or vaccine. Regardless, for
the time being, our healthcare heroes will be required to endure very stressful
situations.

The coronavirus crisis will pass, and we will emerge on the
other side of this mess. When we do, we should hope that our healthcare workers
emerge emotionally and psychologically intact. They deserve at least as much.