In times of general crisis, such as the Coronavirus alert, many people may experience a post-traumatic stress disorder (PTSD) or an aggravation of symptoms already present from the period prior to the COVID-19 emergency.
In these moments it’s important to rely on a consolidated therapy in the treatment of trauma, the EMDR therapy (Eye Movement Desensitization and Reprocessing).
Among the most common symptoms of PTSD are:
- Flashbacks, which can be intrusive images or memories, which burst into the mind and cause severe discomfort. Flashbacks may not just be visual, but can manifest themselves by physical symptoms, such as an unexplained and persistent pain, or with sudden emotional changes;
- the person tries to avoid situations, discussions or thoughts related to the traumatic event;
- a series of symptoms that signal alert, such as a difficulties sleeping, agitated sleep or waking up because of nightmares.
- other symptoms of an excessive alert are: irritability (being triggered even for smaller things), impulsiveness, tachycardia, anxiety, panic attacks, nausea or gastrointestinal problems.
- cognitive impairment such as poor concentration and memory;
- alterated emotional responses: afflect flattening or the inability to feel an expected response to events or situations;
- fatigue, both mental and physical.
An ongoing event such as coronavirus infection can give rise to PTSD symptoms at different levels.
Due to the characteristics of the situation, the traumatic event is not identifiable as a single event, which has a beginning and an end, but is a threat that follows a “wave” pattern.
Every day, with every update, people can undergo a slight alteration.
The coronavirus can’t be seen, it’s intangible, so it’s perceived as a less controllable threat.Finally, a pandemic affects all people around the world, so it potentially represents a collective trauma.
Who are the most at risk subjects for developing PTSD?
Those who have family members or close relatives involved in the infection, who have lost a loved one due to the virus, who are at the forefront of the health service.
On the other hand, people who were already suffering from previous traumatic experiences are at risk of worsening.
In fact, in addition to post traumatic stress disorder in recent decades has also been described the complex post traumatic stress syndrome (cDPTS).
It refers to a more stable picture of symptoms, that usually characterizes the individual for years, unlike PTSD, which is an obvious change after a traumatic incident.
cDPTS is usually particularly rich in symptoms, anxiety, depression, eating disorders, substance or alcohol addiction, and struggle with relationships.
Often in these cases, the individual’s childhood has been characterised by highly dysfunctional family environment, emotional or physical/sexual abuse, serious neglect and lack of protection, warmth and support from the caregivers.
Due to the coronavirus situation, those who were already struggling with cPTSD, may experience a worsening of their symptoms.
The alert, the fear and impotence generated by the latest events, works as a “bridge” with their traumatic past, bringing the unprocessed memories of ancient traumas to the surface.
Therefore the therapeutic strategies of EMDR therapy can be different in the case of a DPTS or a complex DPTS.
When a person with a quite processed life history encounters a traumatic event, and develops PTSD symptoms, the therapeutic work is quite agile.
The therapist will apply standard protocol, and help the patient processing the recent trauma and restore previous functioning in a few sessions. This also applys for people who develop disturbing post-traumatic reactions following the Coronavirus emergency.
EMDR therapy stimulates the capacity of neurological processing of the brain, helping the traumatic information “blocked” in the emotional areas of the brain to transfer to more cognitive areas, as demonstrated by many studies.
The result of this “shifting” is a rapid change in the way the person thinks about him/herself regarding the event and the dissolution of disturbing emotions and sensations. Surprisingly, the memory of the trauma becomes “just a memory”.
It is good to remember that given the current conditions, the perception of a state of alert is absolutely normal and adaptive (positive): without the alert we would not have the possibility to respond to threats and protect ourselves.
In case of disturbing symptoms, which interfere with normal functioning, something different might be happening.
A person who is anxious, unable to rest, irritable and aggressive, fatigued and has flashbacks of the relative being brought to the hospital by the health staff in white suits, needs professional help.
In case the person has many unprocessed traumatic memories, therapy may take longer period and adaptations in therapeutic procedures.
Only therapists who have completed advanced EMDR training beside the basic course can guarantee having the skills to guide these patients treatment.
The take home message is to manage this moment of crisis and the consequent emotional alterations by following simple strategies, such as:
- avoid the excess of information, but dedicate 1-2 moments during the day to update about the Coronavirus infection;
- -choose the official channels of information, avoiding the risk for fake news;
- -choose these 1-2 moments during the day, not close to bedtime, our nervous system needs to rest and process all the informations we have received, all the emotions and take a break from the alert;
- dedicate moments of the day to physical activities (there’s plenty of videos on youtube), exercise may help sleep better at night and relieve some stress;
- don’t isolate, talk with some friends and family through videocalling or texting;
- don’t make the Coronavirus the only topic of your conversations, talk also about something lighter things and continue to laugh for jokes or humour;
- look on the positive side of this forced vacation from work, enjoy the little things that you couldn’t do on a regular schedule, enjoy your kids, enjoy some good movie or series;
- ask for help in case you notice disturbing changes such as those described in this article.