What this shared experience tells us about the nature of trauma
A terrifying fear for one’s safety and the safety of loved ones, loss of loved ones, extreme illness and death, unprecedented social isolation, chronic lack of certainty about one’s life and the future. There is no question that the COVID-19 pandemic presents a serious challenge to emotional well-being and even to mental health more specifically. The chronic lack of certainty, mass job loss, and economic hardships on their own are often enough to destabilize people, let alone the fact that we are dealing with a highly contagious and lethal illness to which any of us may fall victim at any time. While it is thus without doubt that the pandemic is a major stressor and potential threat to mental health, does it constitute an actual trauma?
On the face of it, the pandemic does not neatly fit into models of factors that may lead to the development of post-traumatic stress reactions. For one thing, the pandemic is ongoing and many people’s stress about it has to do with potential future events rather than actual experiences in the past. On the contrary, traditional models of post-traumatic stress response by definition posit that the reaction is in response to something that happened in the past. In addition, most models of post-traumatic stress occur after direct exposure to an immediately life-threatening event. On the other hand, people’s experience of the pandemic is mostly indirect (e.g. via watching the news versus actually experiencing illness and death or near-death) and the stressful events are not immediately life-threatening but are byproducts of the pandemic such as job loss, financial instability, and social isolation. Nonetheless, several studies have already suggested that even under these unusual circumstances people are showing traditional traumatic stress responses to the pandemic.
There are also particular circumstances related to quarantine that may result in an uptick in traumatic stress responses. Family members who may experience abuse in their homes have experienced an intensification of these behaviors during the pandemic, partly as a result of increased stress and partly as a result of more time spent in the home and fewer outlets available to seek help. In addition, healthcare workers, who have been exposed to some of the most horrifying, heart-wrenching scenes of serious illness and death, may also now be at increased risk of developing post-traumatic stress due to their particular experiences during the pandemic.
Beyond what we are already seeing, there is reason to believe that traumatic responses to the pandemic may increase over time. In general, in the midst of a stressful event, people tend to go into “crisis mode,” and it is only when things become more calm and they have a chance to reflect that their mental health that they might start to suffer. It is definitely possible that even as a great number of people are already struggling with their mental health in the midst of this pandemic, those numbers might even increase as (hopefully) the pandemic recedes and life returns to a more normal state. A proportion of those people will likely experience some degree of trauma.
While much remains to be seen about the connection between COVID-19 and trauma, the pandemic is a useful reminder that traumatic events can be slow to unfold, collectively experienced, and even somewhat indirect in nature. It is essential that we be mindful of the fact that even though the pandemic does not neatly fit into our usual notions of trauma, we should be sensitive to the fact that some people might still be experiencing symptoms of post-traumatic stress. This will make it easier to guide more of the many people who are suffering right now to the appropriate form of help. Whether COVID-19 constitutes a traditional trauma or not, the high degree of destruction and uncertainty left in its wake will continue to haunt many people. We must be prepared to help them recover from this terrifying experience of lack of control and persistent fear for their safety and well-being.