Coping with COVID-19 - Part 7: What About People With a History of Trauma?

As difficult as this pandemic is for all of us, it is even more challenging for individuals with a history of trauma. For example, people who were not protected from abuse or neglect as kids often do not know what a sense of security even means. Feelings of safety in one’s own body, in one’s emotions and thoughts, in one’s relationships with others and in one’s place in the world are all undermined by trauma.[1] Therefore, a focus on safety, emotions, interpersonal relationships with partners, peers and kids, and finding meaning in COVID-19 has an extra layer of complexity for survivors of trauma.

Finding ways to regulate one’s emotions and to calm the emotional brain during this pandemic is difficult. Being abused in and of itself is dysregulating. Moreover, it often occurs in households where parents never adequately comfort their kids or where they frequently seem dangerous or unpredictable, perhaps because of their own history of trauma. In many households, the chaos stemming from noise, crowded conditions, poverty or general violence makes a sense of calm seem out of reach. While some trauma survivors report that they are seemingly functioning even better at this time because the chaos due to COVID-19 feels so familiar, they are using crisis-level mechanisms such as dissociation which are not useful in the long run. On the other hand, specific treatment approaches such as Dialectical Behavior Therapy[2] with its focus on mindful awareness as well as distress tolerance, and acceptance may be particularly useful during this time of amplified emotional stress. A variety of other mind-body strategies have been described by Bessel van der Kolk.[3]

Interpersonally, a history of trauma and betrayal by parents who should have been reliable and trustworthy can disrupt someone’s willingness or ability to become connected to others. Therefore, identifying trusted people (such as a certain friend or therapist or minister) who will validate your concerns without heightening your anxiety is invaluable. However, be discriminating in your choice of people in whom to confide. Furthermore, relying on different sources of social support for different kinds of help (practical, emotional, financial) will allow you to avoid overwhelming others who are equally impacted by this pandemic.

Feelings of isolation are common among abuse survivors; ironically, some survivors describe themselves as currently feeling less different from others given that feelings of isolation seem almost universal with COVID-19. They may even be dreading a return to “normality” when they anticipate once again seeing themselves as significantly more separate from others. Those individuals with a trauma history who have a supportive partner count it as a godsend. However, trauma survivors are often more likely to have a partner with his/her own history of trauma. While these “dual-trauma” couples are at particular risk during this time of high anxiety, they too can be helped with approaches such as Emotionally Focused Therapy.[4]

Reassuring and consoling a distressed child is especially difficult now when we are all facing uncertainty as to when this crisis will end. The task is far greater for individuals who are triggered by COVID-19 to remember times in childhood when their parents were unable to soothe them and may even have intensified their fears. However, many trauma survivors have found ways to provide their children with the security that they themselves never received. These resilient individuals are able to do so by virtue of having found alternative sources of support including trusted family members and friends, supportive partners, therapists, and, for some, a perceived relationship with God. That is, they have been able to find people who appreciated them in a way that they never experienced in childhood.

Many resilient trauma survivors have also somehow developed an understanding of their childhood experience. That is, they have developed a conscious awareness and acceptance of both their trauma and its emotional impact on their lives. This template of making meaning may actually serve them well in making sense of the current unimaginable situation in which we all find ourselves.

[1] Herman, J. (2015). Trauma and recovery: The aftermath of violence – from domestic abuse to political terror. New2 York: Basic Books. [2] Linehan, Marsha M. (2015). DBT skills training handouts and worksheets, 2nd ed. New York: Guilford Press. [3] Van der Kolk, B. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. New York: Viking. [4] Alexander, P. C. (2020). Dual-trauma attachment-based couple therapy. In J. D. Ford & C. A. Courtois (Eds.), Treating complex traumatic stress disorders in adults, 2nd edition (pp. 440-458). New York: Guilford Press.