Written by: Trisha Miller, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
When the phone rings, Mrs. Abrams startles, and her heart races. She looks at the phone screen to see who it is. It is not the hospital. It is her son. She tries to answer it, her hands shaking. Memories flood her mind and fill her body. She remembers when the hospital called and said she needed to get there as soon as possible because her husband would not live much longer. COVID was about to take his life. But he somehow escaped the killing and went on to fight, struggling for weeks to wean off the ventilator. After the phone call, her heart slowly returns to its normal rate and rhythm.
She had started on medication for anxiety, and her son took over communicating with the medical professionals. She could not talk on the phone to anyone from the hospital. She just could not. After taking a week off to retreat into medication-induced rest, she was able to see her husband and hold his hand. She encouraged him to keep trying. Her voice softened by her altered state. He smiled at his troubled wife. He would eventually recover, breathe on his own, have his sense of humor back, and be able to walk again. Mrs. Abrams would be able to stop the medication and start smiling again, full of gratitude for the miracle that was her husband.
Another phone rings, and Mr. Baron’s life is instantly transformed when he is told that he is being “let go.” Due to COVID, the business he works for is shutting down. Adrenaline shoots through his veins. Would he lose his house? He had just purchased his first home six months earlier, an accomplishment he had worked long and hard for.
A doorbell rings, and the family looks at one another. Who would be visiting them? No one was allowed to come into their home. They have already lost their grandfather and uncle to COVID. They will not fail to protect themselves. They have learned a tragic lesson. The living room is suddenly filled with fear and mistrust.
Two friends talk on the phone, and their voices begin to fill with tension. They disagree about whether their children should return to school. One thinks it is necessary for her child to be adequately educated and to socialize with peers. The other feels certain that if her child returns to school, he will bring home the virus and infect her aging mother, who lives with them. Both friends are adamant, and they both feel mistrust.
We have been traumatized by the effects of COVID-19 on individuals, families, businesses, communities, societies, nations, and the world. Our trauma came in many forms: death, severe illness and debilitation, loss of jobs, disconnection from friends and family, restrictions everywhere, including children not going to school and seeing their friends, and economic fallout including evictions, failed businesses, and homelessness. Our trauma extended to extreme mistrust of leadership and government to protect us from the virus and rescue us from this fallout. Our mistrust expanded to conspiracy theories and blaming China for creating this disaster.
The symptoms of PTSD can be seen in our individual and collective Post-COVID Traumatic Stress Disorder (PCTSD). These include nightmares of people dying, unwanted memories (like the phone call from the hospital), avoidance of situations that bring back memories of the trauma, heightened reactions, anxiety, and depressed mood. Behaviorally, this takes the forms of agitation, irritability, hostility, hypervigilance, self-destructive behavior, and social isolation. Psychologically, this can include flashbacks, fear, severe anxiety, and mistrust. The mood is affected and can include loss of interest or pleasure in activities, guilt, and loneliness.
Insomnia is common. And finally, emotional detachment and unwanted thoughts can occur.
Refusing to wear a mask could be interpreted as avoiding being reminded that the virus is killing thousands of people a day. Self-destructive behavior comes in the form of increased rates of alcoholism and suicide. We feel guilty for potentially spreading the virus unknowingly, so we become more rigid with protective behaviors, including never going into a grocery store. We are filled with mistrust of others, not knowing what they do outside of work or outside our “pod.” We become irritable and sometimes agitated about our circumstances. Children are angry at COVID for keeping them from their friends for so long. We are filled with dread about another “wave” of death and destruction, if not from Covid, then from some new viral enemy.
Has COVID-19 affected how we treat each other? We have always had racism in this country. COVID has intensified the mistrust and anger that underlies racial behavior. Asian-Americans have been increasingly targeted with violence, connecting them with the conspiracy theory that China created this virus to attack us. Hate crimes against Asians in this country increased by over 200% during the pandemic. Post-COVID Traumatic Stress Disorder has increased agitation, mistrust, heightened reactions, irritability, hostility, and hypervigilance. If a person was prejudiced before the pandemic, our collective PCTSD intensified it, leading to increased racial and ethnic conflicts. Brutality by law enforcement on black men and women became undeniable as phones videoed the harsh realities. People of every race watched these videos, taken up close, showing the true personal experiences of racial violence. These scenes and images then became further traumatizing to us collectively.
We want to get vaccinated and immediately attend concerts, cheer at major league baseball games, and throw big parties celebrating our return to freedom. We see the light at what we hope is the end of the tunnel, and we are rushing toward the light. We envision ourselves relieved, with the dark clouds lifted. Certainly, we will be happy at last, we assume.
However, trauma takes time and well-thought-out interventions to heal. The effects of trauma can suddenly burst forward when triggered, even amid our celebrations. When it does, will we recognize it as a symptom of PCTSD? If we do not, our healing will be prolonged; our symptoms could even get worse. If we recognize this, we can develop informed interventions, especially at the societal level.
Will our collective heartbeats eventually return to normal rate and rhythm, like that of Mrs. Abrams? What will it take for us to heal?
First, it is important to know that PTSD is difficult to treat and takes an exceptionally long time to heal. Treatment requires a professional who is trained and experienced in the treatment of PTSD. Time alone is not sufficient.
Treatment includes exposure to the traumatic memories with professional support in a manner that helps the individual feel safe. The individual is taught techniques for pulling themselves out of the time machine that forcefully takes them back to the trauma. Meditation and yoga can assist the person in strengthening their ability to stay in the present. The stress response of the body, heightened with PTSD, is calmed through an increase in self-awareness and self-care. Coping skills are a necessary focus to rebuild resilience. Exercise increases both physical and mental strength and confidence. Group therapy can provide validating and inspiring support. The therapist-client relationship helps the individual begin to trust again, a step toward learning how and when to trust others. And finally, the individual must feel and process grief, forgive themselves for what they [possibly unconsciously] blame themselves for, and build trust in themselves.
Can these methods be utilized to help groups of people heal? An essential component of any therapeutic approach is trust in the therapist or, in the case of a group, the people attempting to facilitate the healing process. Establishing that trusting relationship is the first step. Who is currently attempting to help us heal from the trauma of COVID? It appears that, in our country, it is our state and national leadership and the CDC. How will we be able to trust these people who are responsible for our healing? Furthermore, our current generalized mistrust is an after-effect of COVID on an individual's brain and a PCTSD symptom of the group.
A powerful example of this on the individual level was reported recently in a reputable news publication. “Like a light switch, it happened this fast, this intense paranoia hit me, Ivan Agerton said in interviews. “It was single-handedly the most terrifying thing I’ve ever experienced in my life.” Agerton, a former marine described by others as a “a very self-aware, in-control-with-chaos guy,” had no prior history of mental illness. But after a mild case of COVID-19, he plunged into a state of hypervigilance, paranoid delusions, and auditory hallucinations that lasted months and required psychiatric hospitalization twice and anti-psychotic and anti-anxiety medication. He very slowly and gradually improved but remained fearful the psychosis would return. This post-COVID psychosis is being increasingly reported.
The New York Times discovered this mistrust on a group level when they asked their readers to write in and tell them how the virus has affected them. One person wrote, “For me, the pandemic has made the staggering demise of this nation’s collective faith in government abundantly clear to the point of absurdity.” Many who wrote in and can be heard in almost every setting in the country; in barbershops, family gatherings, co-workers sharing lunch, and friends talking on the phone. COVID has created mistrust and has exacerbated our pre-existing trust issues.
The ability to trust is to see and accept reality and have confidence in our ability to cope with what we fear another might do. If a mother feels mistrustful when her daughter is assigned to a male teacher for tutoring, she is certainly not naïve. The reality is that some men are sexually inappropriate with teenage girls. There is also the reality that the school is liable for the safety of their students and therefore takes precautions to protect them. It is not JUST the mother’s job to protect her daughter in this situation. When she sees this as a shared responsibility with the school and explores how the school prevents and monitors these risks, she gains confidence in them. When she explores her OWN ability to protect her daughter and deal with her fears, she sees that she can coach her daughter to be empowered to protect herself. The mother also sees that she can cope with her worst fears and get her daughter and herself professional help if her fears are realized.
Let us apply this to our current situation with PTSD. We must be able to see and accept reality. The reality of COVID is found in statistics of new cases and deaths reported to us daily and reports from the CDC on the latest research findings of how the virus is transmitted. Even more poignantly, the reality is felt as we see on tv body bags stacked in refrigerated semis and communities struggling to find places they can bury their dead. Recent research reports that one in three people knows someone who has died from COVID. Acceptance of this reality would lead a person to unambivalently wear a mask out of fear of catching or spreading the virus and to feel great sadness about the number of deaths this virus has caused.
Next in the process of developing trust is to have confidence in our ability to cope with what we fear may happen. We have, indeed, lost our confidence in this matter. When we look back over the last year, we see poor coping. We see indignation at needing to wear a mask, inadequate PPE supplies, and politicizing this public health threat.
Lastly, to trust, we need to see empathy, compassion, integrity, and reliability in those we need to trust in. With the political turmoil of the past year, many people could not find any of these qualities in national leaders. Our new leaders face a hard battle to regain trust. They must demonstrate empathy and compassion for the losses we have suffered. They must act in accordance with valuing human lives. They must do what they say they are going to do to protect us. We see examples of empathy when the leaders visit graves of those who have died from the virus or when they lead us in a moment of silence for those lost. Compassion is felt when we see leaders seeking to address the financial burdens caused by this virus. We perceive integrity when leaders report facts based on science rather than political agendas. Reliability is demonstrated by follow through on promised changes in laws that are needed to restore peace in our own country.
Indeed, our leaders have hard work ahead of them to restore peace in own country. Their efforts will need to cover many bases in addition to the multiple challenges associated with managing this pandemic. Vaccines and masks will not calm our social unrest. Violence and hate crimes must be acknowledged, and genuine intolerance must be expressed. Actions must follow.
President Biden and Vice President Harris visited Atlanta and condemned the shootings and rising hate crimes against Asian Americans. Biden stated, “…hate and violence often hide in plain sight. It’s often met with silence. That’s been true throughout our history, but that has to change because our silence is complicity.” Actions followed when legislation was introduced to ban assault weapons and increase oversight at the Justice Department of coronavirus-related hate crimes.
As trust builds in our leaders, “interventions” can be pursued to address our societal symptoms of PCTSD. In Florida, a program is being implemented to teach children and teenagers “Computer Literacy.” This program seeks to give youth the skills to recognize misinformation on social media and the internet. In some cities, volunteers are organized to escort elderly Asian Americans as they walk to local destinations. Psychotherapy is now readily available via Zoom and advertised on social media, normalizing this method of gaining self-awareness and support. Exercise and yoga teachers and coaches offer classes online as well.
Coronavirus has shown us our true colors, and some silver linings have appeared. During our lockdown and shutdown of sources of the arts, we have seen some innovative and inspiring efforts to keep access to the arts alive. Musicians play music on their balconies to the audience of their neighbors. Choirs sing on Zoom, and their voices are heard through YouTube videos. Art galleries offer virtual tours. Performing arts are kept alive with cast members recording scenes in their homes or outside and making this available to the public for a fraction of the price of a ticket to the theater.
Many patients who have come back from the edge of death and survived COVID express their renewed appreciation for time with family and the importance of taking better control over their health. This silver lining is common, and if it lasts, it could change our cultural priorities away from workaholism and self-neglect and toward family-centered life and better health. This would have systemic effects, such as better parenting, lower crime, lower rates of drug addiction and suicide, higher rates of high school completion, and lower health care costs, among many other things.
Post-COVID Traumatic Stress Disorder will be with us for quite some time. We have within us the capacity to heal and even grow from the traumas associated with this pandemic. We need strong leadership as well as strong bonds between us to recover. With determination, we can emerge better than before.
Dr. Trisha Miller, Executive Contributor Brainz Magazine
Dr. Trisha Miller is a Patient Advocate at a hospital in St. Louis, MO, and a Life Coach to clients in various parts of the country. Her decades of experience as a Ph.D. Clinical Psychologist informs her current work. Having worked as a psychologist with individuals of all ages and with almost all challenges, she can quickly understand the needs of the patients and clients she now works with. As a Patient Advocate, she assists patients going through major medical issues, such as those related to COVID, as they struggle to win their battles with illness and injury. She is a Certified Patient Experience Professional. As a Life Coach, Dr. Miller works with individuals looking to face personal and/or professional challenges and growth with the support and advantage of experienced, expert guidance.
