Self-isolation – is this setting us up for psychological trauma?

Life has changed dramatically for everyone worldwide over the past few months.  I believe that the analogy that equates the current situation related to Covid-19 as being as if we are all in the same storm, yet we are all in different boats, is very accurate.

Groups of us might well be in the same boat, but people are experiencing this in very different ways.  For example, everyone will be experiencing stress related to different current experiences, for example related to; finances, work, uncertainty related to the general situation, home-schooling, their health or the health of loved ones, being isolated and on their own or in lockdown with young children and no outdoor space etc.  Previous experiences will also be playing a part in how we feel because current experiences might also be triggering memories of past traumas/stressful experiences.

However, one of the main factors that has the potential to cause psychological trauma is due to the enforced isolation and lack of connection from being in lockdown.  Humans are tribal people and connection is a primal need, even for introverts.  In fact Gabor Maté MD, who is a specialist in trauma and stress, teaches about the science of connection and how stress and the lack of connection in childhood is the root cause of addictions and many other mental and physical health problems.

Bessel van der Kolk MD is another Doctor who has devoted his life to studying trauma.  His work includes research studies looking at what factors are involved in setting us up for potential psychological trauma.  He also looks at interventions and treatments that could potentially help reduce this risk as well as relieve the symptoms people experience in relation to past trauma.

The work I have been involved in since 2007 is aimed at helping people with chronic pain and other persistent symptoms gain relief and regain their lives.  The science base is constantly growing and evolving and although many of my clients have not experienced adverse childhood experiences or current/past trauma, the evidence does now show an undeniable link between stress and trauma and the development of chronic pain and other health problems.  As I explained in my TEDx talk in 2019, if we are to have a fighting chance of helping people with persistent or recurring symptoms, we need to not just address the physical presentation, but encourage people to consider and address the impact of any current or past stress or trauma.

Fight, Flight or Freeze

When stressed our primal brain unconsciously and automatically reacts to try and protect us.  This might be in the form of our ‘flight or fight’ response or it could also be in the form of a ‘freeze’ response.  These responses are meant to be short-term and to aid our ‘escape’ from a threatening situation, such as in the case of enabling a deer to run/flee from a lion/predator or a lion fighting off another lion.  Once activated, the ‘fleeing or fighting’ allows the animal to physically discharge the pent up emotional energy and metabolise the neurochemicals that were triggered in order for them to be able to react appropriately to the threat.

The ‘freeze’ response is triggered when the situation seems helpless or hopeless and again it is another primal protective response, but this time not just to any threat, but to what is perceived to be a threat to its life.  This can be seen in this clip where a cheetah has captured an impala and the impala’s unconscious life-preserving reaction is to ‘play dead’.  This unconscious primal reaction not only results in an increased pain threshold for the impala (so it won’t experience much pain if the lion causes significant tissue damage before they die) but it also offers it a chance to escape if the cheetah thinks it’s dead and their attention wanders.

As you will see, when the cheetah sees the hyena and runs away, this triggers the impala to come round and it is soon able to run away.  In this case the body tremors as it comes around and along with physically running away this helps discharge the build-up of ‘pent up emotions’’ which had been triggered.

These days humans don’t often have physically life-threatening situations, but our primal brain is still constantly on alert, trying to protect us from any potential threats. These days the threats we face tend to be psychological, such as those related to: work, relationships, finances etc. Unfortunately, we humans now have the prefrontal cortex/‘thinking’ brain. This therefore often results in us creating sometimes significant self-induced stress through over-analysing, anxiety, ruminating over ‘what ifs’ etc, often well after the initial psychological stressor has passed.

We are also less physical these days and when the ‘fight or flight’ response is triggered in our day to day life, we generally don’t physically discharge emotions that have been triggered by the perceived threat.  Add these unresolved emotions to those we create through worrying, over-analysing and anxiously focusing on the ‘threat’ and you can see how these can build up.  Evidence shows how this can then impact us not just emotionally but ultimately physically and mentally.

With that understanding and considering psychological trauma, Peter Levine PhD describes a true event in his book, ‘Waking the Tiger: Healing Trauma’.  In 1976, 26 children were kidnapped in California and imprisoned in an underground vault for 16 hours until they were able to escape.  Dr Levine explains how as time went on, most of the boys became ‘frozen’ and apathetic, feeling helpless and hopeless. The boys experienced significant symptoms of post traumatic stress disorder (PTSD) following this experience, which included: ‘nightmares, violent tendencies and impaired ability to function normally in personal and social relations.’

All apart from one boy who was less severely affected.  This was because he was the one who remained actively mobilized as he tried to dig their way out and managed to mobilise the other boys to help and then flee their ‘tomb’.

Covid-19 Lockdown 

This current ‘lockdown’ also has the potential to set people up for trauma, which is why it is so important to understand what we can do to help ourselves.  According to Dr Kolk, the factors that can potentially set us up for trauma are; immobility, lack of predictability, loss of connection, numbing/spacing out and also the loss of sense of time/sequences, safety and purpose.

When working with clients who come to us for help with chronic pain and other persistent health symptoms/conditions (both physical and mental), these areas are all considered as we support them to gain balance in their lives by nurturing themselves mentally, physically, emotionally and spiritually.  By doing this and helping them safely acknowledge any past unresolved emotions as well as learning to self-nurture, have self-compassion and become more emotionally aware we are able to help them relieve their pain/symptoms and over time regain their lives.

Usually I work with clients individually but because of these challenging times and people’s fears about their health and finances, I am also currently running a free Mindbody Wellness series of weekly webinars.  This is available for anyone to support and guide them through these challenging times whether or not they have symptoms because the approach is educational and self-empowering and therefore also beneficial for anyones’ health and wellbeing.  Although an understanding of the concept on which our work is based would be helpful and this can be found in my book, ‘Chronic Pain: Your Key to Recovery’.  It is also available on kindle and audio.

Tips to reduce the chance of psychological trauma

In the meantime, below I have listed the factors which Dr Kolk suggests could potentially set us up for trauma and I have included tips for each. We go through all this and more in detail in our Mindbody Wellness webinars where there is also more support and guidance about how we can improve our health and wellbeing.

• Lack of predictability – Timetable things into your day to do regularly and fit in activities or get-togethers online into your calendar so you have things to look forward to.
• Immobility – If you can, go outdoors for a walk or a run or spend time gardening. If not, then why not follow some of the online yoga or exercise classes or maybe Qi Gong and Tai Chi?  Even skipping or pounding on a mattress or using a pillow to hit the bed can be a great way to expend energy and mobilise emotions, reducing the risk of taking out your feelings on a family member when unresolved emotions build up.
• Loss of connection – This is where using online video platforms to chat to family and friends come into their own, especially if you are on your own a lot. Part of our primal need to connect includes being able to see facial expressions and having eye contact.  This isn’t possible on the phone so the benefits you gain from video calls can be much more effective, especially at the moment.  Eating together as a family is also important during this time in order to really connect with each other, as well as games, quizzes, singing together etc.
• Numbing/Spacing out – People are talking about being more tired, overwhelmed and demotivated with less energy and there can be a tendency to ‘space out’ by drinking, eating too much or constantly watching the news. It can help to notice how you feel and rather than distract yourself, express how you feel on paper. Then put things into perspective and consider what you can practically do now to improve your current situation. For example consider how you can make yourself feel more alive, such as: doing something creative, gardening, singing, dancing.  Be mindful in the moment, rather than numbing yourself and bottling up how you feel.
• Loss of sense of time and sequences – When going through times like this we feel it will go on forever, but nothing stands still. Time, the seasons, plants, emotions etc, they are all ever-changing so allow yourself to feel hope and consider things you could do in the future.
• Loss of safety – When life is so unpredictable, we don’t feel safe because we aren’t in control of anything. Learning to self-soothe and feel safe in our own environment can be really helpful. Finding time on your own can help, especially if you are in a house full of people. Touching and hugging people or pets will boost positive neurochemicals to help you feel safe and secure.  If you have no-one to hug, even closing your eyes and imagining yourself being cuddled in a big lap or cuddling something or someone can help you feel more grounded and secure. Consider what helps you feel safe, maybe even just putting on your favourite music and snuggling up in a chair.
• Loss of sense of purpose – For many this is a very real concern, just as it often is when someone retires after a busy career. Finding something to do that has meaning for you can really help you gain some focus and a sense of purpose. This might be becoming involved in a project at home or doing some voluntary work such as making scrubs or helping those less fortunate in some way, even if that’s just calling them every day.  Creative hobbies can help here too even if you need to be creative to consider what you can do from home!