5 Steps to Working Through Trauma, According to a Therapist Who Works with First Responders
The one word everyone is using to describe their feelings right now? Overwhelmed.
In unprecedented times, it can be comforting to look at the people serving others as a reminder of human perseverance and the fact that there's still good in the world. To learn more about how to stay positive during times of intense stress, why not look to the person who helps those people on the front lines cope?
Laurie Nadel, a psychotherapist located in New York City and author of The Five Gifts: Discovering Healing, Hope and Strength When Disaster Strikes, has spent the past 20 years working with first responders, trauma survivors, and people living through times of immense stress—including children who lost parents on September 11, families who lost homes during Hurricane Sandy, and teachers who were present at Marjory Stoneman Douglas Elementary during the shooting in Parkland, Fl. And now, her patients include many medical first responders who are fighting the COVID-19 pandemic.
"I call first responders empathy warriors," says Nadel. "They're professionally trained and skilled at putting the lives of other people first." Yet, according to Nadel, they're all using one word to describe how they're feeling right now: overwhelmed.
"When you're exposed to disturbing events, it creates a visceral, physical constellation of symptoms, which can include a feeling of helplessness and a sense of dread—and even professionals have these feelings," says Nadel. "These extreme feelings are normal because you've been in an extreme situation."
There's a good chance you feel that way too, even if you're sheltering in place. Trauma during these uncertain times isn't exclusive to first responders (or, in the case of the coronavirus pandemic, front-line workers, medical professionals, or people with direct personal exposure to the virus). It can also be triggered by seeing disturbing images or hearing upsetting stories—two scenarios particularly relevant while under quarantine, when the news is wall-to-wall COVID-19.
What people are going through now is acute stress, which can actually feel similar to PTSD, says Nadel. "A lot of people are reporting disturbances in sleeping and eating patterns," she says. "Living through this is mentally very tiring because all our frameworks for normalcy have been yanked away."
Though first responders have been trained—in school and through on-the-job experience—to handle stressful situations, they're only human, and need skills and guidance to cope, too. (See: How to Cope with Stress As an Essential Worker During COVID-19)
Nadel came up with specific stress management techniques based on the experiences and reactions of first responders—what she calls the five gifts of perseverance—to help counsel them and anyone else directly impacted by tragedies. She's found that these steps help people move past the grief, anger, and continuing anxiety that stems from the trauma they've experienced. Nadel outlines a mental process for those in the midst of a critical situation that can help them break down and effectively face each challenge as it comes. (She's found that people typically face symptoms in this order, although she encourages people to be gentle with themselves if they experience them differently.)
Here, she walks through each of the "gifts" or emotions and how they could be helpful during this time—for both first frontline workers and those quarantined at home.
"It's very hard to come to terms with something unthinkable," like a natural disaster or a pandemic, says Nadel. "But humility helps us to accept that there are forces greater than we are—that not everything is in our control."
"We become humble when the world shakes us to our roots and we begin to examine what's important in our life," says Nadel. She suggests taking five minutes to reflect on the things that really matter to you—even if they're affected by the coronavirus (or another tragic event in question), in which case you can reflect on your takeaways from the good times. After the five minutes is over, make a list of those things and reference it in the future when you begin to worry or feel overwhelmed, similar to a gratitude practice.
When we all return to the routine of your daily lives, it will be easy to forget that a lot of people are still mentally (and maybe physically) struggling from the effects of COVID-19, whether they knew someone whose life was upended or whether they experienced tragedy themselves. During this aftermath, it'll be more important than ever to find patience during the healing process in both yourself and others. "Patience will help you understand that you may still be feeling wounded after the event is over and those feelings can come back at different times." There's likely no finish line or end goal—it'll be a long process of healing.
If, after the lockdown is lifted, you're still worried about another quarantine or your job—that's normal. Don't get angry with yourself for continuing to think about this even though the news has moved on.
"We're seeing a lot of empathy now through connection and community," says Nadel, referring to the outpouring of community support for nonprofits and food banks, as well as attempts to support healthcare workers by raising money, donating personal protective equipment (PPE), and cheering during shift changes in larger cities. All those things are wonderful ways to exercise empathy in the current moment to help people get through this tough time. "But we also need is sustainable empathy," says Nadel.
To achieve this, Nadel says we need to be cognizant that other people—both first-responders and others who were quarantined or experienced personal losses—may take longer to heal, and we should be supportive of them in the future. "Empathy recognizes that the heart has its own timetable and healing is not a straight line," says Nadel. "Instead, try asking, 'What do you need? Is there anything I can do?'" even after this initial period of uncertainty is over.
An important part of the healing process is forgiving yourself because you weren't able to stop this from happening in the first place, says Nadel. "It's natural to feel angry at yourself for feeling helpless," especially when there isn't someone or something else concrete to blame.
"Everyone's looking for a villain, and sometimes these things are just not understandable," she says. "We have to work to forgive whatever forces are responsible for having had this much impact and forcing the kind of changes into our lives that we don't like—like isolation under quarantine."
Nadel also points out that the confinement of lockdown can easily trigger irritability—to fight this, she encourages people to practice forgiveness beginning with the people around them. In forgiving yourself and others, it's important to spend time recognizing the positive, empathetic, strong qualities—and to remember that, in most cases, people are trying their best under tough circumstances.
"This step will come when you can one day look back at this event and say, 'I wish that had never happened and I would never wish it on anybody else, but I wouldn't be who I am today if I hadn't learned what I needed to learn by going through it,'" says Nadel.
This gift can also help you push through the difficult moments to get to that point; what this gift provides in the present tense is hope, she says. You can use it as a form of meditation. Take a moment to focus on the future wherein you can "feel what it's like from the inside-out to have grown stronger because of what you have learned from this period of hardship."
Try making a list of all of the good things that have come out this hardship—whether it's an increased focus on family or a commitment to be less tied to your social media accounts. You can also write down the hardships that were faced so that you can remember to be gentle with yourself and others as you move forward.