John takes a look at COVID-19 through a trauma-informed and recovery focused lens.
As a counsellor, I have worked with people facing addiction, mental health problems, homelessness and trauma. One question that hangs in the air is ‘Am I normal?’ People want to know if their problem is extreme or fairly typical and treatable.
One plank of a therapeutic intervention is to ‘normalise’ people’s experiences. When people see literature describing their problem, the relief felt can induce tears. Knowing you are not alone or an outlier alleviates distress in itself.
The great truth that ‘it’s not what’s wrong with you; it’s what happened to you that matters’, is a revelation to people in distress. It helps to know your distress is a sane reaction to insane circumstances.
COVID-19 and the post pandemic narrative
If ‘normalisation’ is one approach to distress the flip side is ‘abnormalisation’ or pathologising distress. Fear becomes anxiety disorder. ‘Coronaphobia’ has been presented in newspapers as a condition that will prevent sufferers returning to work after the lockdown.
The post pandemic story can be a disaster narrative:
- ‘Catastrophic mental health crisis.’
- ‘Pandemic causes a spike in mental health problems.’
- ‘Covid-19 pushing America to looming mental health crisis.’
Lancet Psychiatry (21 April 2020) (this link will take you away from our website) reports that “Those with psychiatric disorders might experience worsening symptoms and others might develop new mental health problems, especially depression, anxiety, and post-traumatic stress (all associated with increased suicide risk).”
A post pandemic narrative of pathology and mental illness will result in psychiatric referrals, medication and citizens re-designated as patients in need of expert help.
It’s okay to be scared
Let’s be in no doubt. COVID-19 is frightening. People are dying. Our lives have been turned upside down. The ‘new normal’ is abnormal and alien. Livelihoods are at risk. Hopes and dreams dashed. For those already beset by poverty, disability and exclusion things are worse. Uncertainty is the only certainty. Our primal defences have been triggered, fight flight and freeze, all of which are useless against a virus. Some retreat into denial ‘I can’t wait to get a flight to the sun’. Others dissociate mildly into a fuzzy brained dwam. Fear, anxiety, grief, loss and sadness are all appropriate and natural responses to this invisible enemy.
Detecting post pandemic growth
One of the less discussed aspects of trauma is ‘post traumatic growth’. Certain aspects of people’s lives can be better after the event. The cancer survivor with a new perspective on life. The trauma survivor who becomes a ‘wounded healer’. Collective surges in kindness and altruism. From our new perspective we see who the important workers are. Those in shops, services, transport, health, social care and so on are viewed with admiration and gratitude. We literally applaud them. The perennial and wicked problem of homelessness is eradicated in one night. We now understand that with political will these allegedly intractable problems are soluble. Prisoners can be released. Food parcels can be delivered. We live in a world of possibilities.
The choices are ours
The pandemic is a source of fear, up to and including fear of death itself. We can choose to view these emotions as the normal and expected response to a deadly threat. We can embrace our vulnerability. Acknowledge that life is fragile and precious. Flowing from this comes respect for ourselves and others, kindness, concern for the environment and a new sense of values and priorities. We are interdependent. My safety depends on your behaviour and yours on mine.
Let’s make the new normal much better than the old one.
John is a psychotherapist and consultant trauma and recovery trainer. You can follow him on Twitter – @RecoveryJohn1 (this link will take you away from our website) – and watch his videos on YouTube (this link will take you away from our website).
This Opinion is part of a specially commissioned series by the ALLIANCE’s Academy programme looking at COVID-19 and the Five Provocations for the Future of Health and Social Care. The Academy has published an Insight Paper that explores research on Adverse Childhood Experiences (ACEs), Scotland’s response to this concept, and how ACEs could transform health and social care. We have also organised public screenings around Scotland of the documentary, Resilience (this link will take you away from our website), which looks at the effects that toxic stress can have on children’s brains, putting them at risk of ill health and how ACEs can be prevented.