Trauma
In the United States, there has been an increasing awareness of the impact of traumatic stress on mental health.
Many times, when people think of trauma, they think of war. If you ask most people, "What is PTSD?" They will respond, "Don't a lot of soldiers come back from war with PTSD?”
PTSD (Post-Traumatic Stress Disorder) certainly affects many soldiers. It also affects victims of sexual violence, kids who see their parents get into fights, teenagers who witness gun violence, and families who lose their homes to hurricanes.
Trauma is a threatening event or series of events.
Traumatic stress is stress that is activated after trauma occurs, sometimes in response to perceived threat, even when none may exist.
There are many models of therapy to treat trauma, including those specially designed for children and adolescents, like Trauma-Focused Cognitive Behavioral Therapy or the Attachment, Self-regulation, and Competency Framework.
I have recently been thinking about trauma and the COVID-19 crisis.
As a psychologist, I am careful about assigning a diagnosis of a traumatic stress disorder to kids. Understanding how traumatic stress plays out in children requires careful assessment, including taking inventory of children’s protective factors and risk factors.
Traumatic stress is complex, in that two people can experience the same traumatic event, but have very different reactions. In order to be diagnosed with a traumatic stress disorder, children and adults need to meet specific criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
Folks are reacting in varied ways to the COVID-19 crisis. Without fitting those reactions into a clinical definition of trauma and traumatic stress, I believe that three broad treatment principles related to trauma and traumatic stress are applicable to our cultural moment:
1. Engage your emotions: A hallmark of traumatic stress is the drive to avoid a reminder of the trauma. Instead of ignoring your emotions about what is happening, take the time to take inventory of what you are feeling related to the COVID-19 crisis. Ways to do this could include taking a walk once a day and sorting things out, journaling, or sharing with a trusted other.
2. Remember your body: A trauma expert, Bessel van der Kolk, wrote a now well-known book called The Body Keeps the Score. The titled is based on the idea that even when we are not consciously thinking about the impact of trauma, our bodies are keeping track. Physical impact of traumatic stress has been well-documented in the ACES study, and most of us can look back at times in our lives when we were even just a little stressed, and see the impact of stress on our body. Take time to care for your body. Take a walk, eat three square meals a day, limit your sugar intake, play a fun sport with your kids, or even play a musical instrument to get out of your head.
3. Keep your rituals: Work to keep a regularly occurring schedule of activities during the crisis, such as waking at the same time of day, dressing for work (even from home), and even silly things like watching your favorite show on Wednesday. Rituals have a way of grounding us, even when there is a true crisis at hand.
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