This post is devoted to all people who are directly fighting
COVID-19 right now,
such as individuals
who are diagnosed, patients, medical professionals, or first responders
of all kinds.
I would like to start by stating several basic
things:
1) I have a lot of compassion for your situation. I am very sorry that you are
between the rock and the hard place right now.
2) Your pain is real and it deserves care and respect.
3) There is nothing I or anyone else can do to fix your pain
and suffering; however, there is something you can do to alleviate it to some
extent – this is what the post is about.
4) Even though it might feel this way, you are NOT alone;
even if it feels that you are fighting for or against the whole world on your
own right now, there is at least your internal compassionate witness that is
present there with you and, at most, Higher Power (of your understanding). Of
course, there are also multiple people around the country and the world, who
are experiencing similar struggles.
In the next two posts, I will review
the impact of acute trauma on human brain and nervous system, ways to cope with
acute stress during demanding and catastrophic situations, and ways to reduce probability
of psychological traumatization, which is often an outcome of an extreme hardship.
Impact of acute
trauma
When we, as human
beings, face the situation of overwhelming need and suffering, which is what
autonomic
nervous systems tend to get overwhelmed and push us out of our regular
functioning modes into survival responses.
For some people, it means being in the state of hyperarousal (fight or flight
response) which manifests in
the increase of anxiety or agitation, frenetic energy, difficulties sleeping
with possible flight of ideas and difficulty focusing or with tunnel vision and
hyper concentration. Maintenance of this state requires a lot of internal resources.
It is not sustainable over the long term. However, a lot of first responders,
as well as doctors and nurses in critical care, will be functioning in this
state for a very long time. For other people, survival mode is associated with
the state of hypoarousal (freeze response), which manifests in slowing down of
cognitive processes, low energy levels and fatigue, depressed or blue mood,
sometimes to the point of feeling paralyzed or disconnected from themselves or
others. This is the mode that a lot of ICU patients will be finding themselves
in.
you are facing right now, our
It is also common
for folks to go between these two modes multiple times a week. For example,
being in “fight or flight” state at work and then shifting into “freeze” response
once off the shift. Living in either one of these states for a long period of
time is very taxing for our bodies and our souls. It often leads to us being more traumatized in
the end of the catastrophic situations.
On the level of
the brain, when we are outside of
our regular nervous system functioning mode, our frontal lobes tend to go
offline. They are responsible for us being able to critically evaluate
situations and make sound decisions based on facts and data. When we don’t have
access to these areas of our brains, we tend to make more mistakes and lapses
in judgment. At the same time, amygdala, the area of our brains that processes
threats, gets over-activated and pushes us to look at events and people through
the lenses of fear and danger. This often results in us being overly reactive
and impulsive in our decisions and actions.
In terms of our psychological and social functioning, the shift into survival mode
often leads to us feeling disconnected and alone. Empathizing with ourselves
and others becomes a real challenge. We may feel anxious, angry, sad,
overwhelmed, guilty, ashamed or a combination of those emotions most of the
time. We may become intolerant of other people’s traits, actions, mistakes. We
may also develop negative and/or hopeless perspective on the world, future, or
our own prospects. It may become
difficult to stay embodied, meaning connected to our bodies and aware of
our needs. We may struggle with balancing other people’s needs and demands with
our own needs.
Coping with acute
stress
When we are in
the middle of a critical situation we often need to “collect
ourselves” and act. In these circumstances we often have to neglect our own
needs. We are often called to do more than we humanely can. How can one cope
with those overloading demands? Few suggestions below are not a cure or
a magic wand; however, following them may help take some pressure off.
1.
Protecting your
vulnerabilities.
It is important
to shield tender and vulnerable sides of you. We all have them, and we all get
hurt when they are present in the harsh environments. So, let us focus on
several steps of protection. (If you have even a few minutes after you read
this article and there is only one practice you can do, I invite you to focus
on the next three steps of protection.)
Step 1. Create an internal safe place.
Simply imagine a place where
young and tender aspects of you will be comfortable. It maybe a cabin in the
woods, a bungalow on the beach, or a cave in the mountains, or anything else
that calls your name. Really develop this place in your mind’s eye so that you
can see the colors and experience the smells. Your vulnerable parts can have
anything they need for life and comfort in that spot, for example, food, pets, blankets,
toys, etc. Now, invite your young and vulnerable sides to come to that place
and explain to them that this is a place for them to be when you are in crisis
situation, whether it is at your work, in the hospital, in the ICU or somewhere
else.
If you are not a very visual person,
you can create a safe place in your body, such as behind your heart or in your
gut.
Step 2. Invite your parts to stay in a safe place
Before you go into a high demand,
scary, or crisis situation, invite your vulnerable aspects to go to a safe
place and stay there until you let them know it is over. Let them know that
they do not have to participate in anything that is about to happen or track
anything. They can simply put headphones on and rest or do what they like.
Reassure them that adult sides of you can take care of work or crisis and that
you will let them know when it is safe to come out.
Step 3. Check in or invite parts out. (very important and makes the
whole practice work).
When you reach respite, whether it
is the end of the shift, temporary relief from pain, or any other moment of
safety, check in with the parts in a safe place to let them know you remember
them and reassure they are not alone. When the situation is over, let the parts
know that they can come out of the safe place and join you again. Please, do
not simply exile or abandon your younger and vulnerable parts in that safe
place. It will be hurtful rather than helpful in the long run.
2.
Checking,
keeping, and regaining perspective.
In the midst of chaos, it is very easy to forget simple facts.
When you have a moment to breathe, maybe when you are going to the bathroom or
before you pass out in your bed, remind yourself:
* the situation is much bigger than you
* you are only ONE person doing the best they can
*it will pass too
*Higher Power (God, Community, Family, whatever calls your name) is there for
you and has your back
3.
Hand on the heart
– 1 min practice
For the next minute,
bring your hand to your heart area, focus on the contact between your palm and
your chest, feel the warmth emanating from your hand and say to yourself
something like: “I know this situation really sucks. I know it is hard and
painful, and I am sorry. I see that you are doing your best. I love you and I
accept you just the way you are.” Feel free to modify those phrases so that
they sound true and authentic to you. The important thing is that words express
validation, understanding, and acceptance of you as a person.
4.
Mindful Movement
It does not have to
be anything fancy like a yoga practice or a pilates session. Simply walking
down the hall with the full attention to your feet hitting the ground and
awareness of your breath is a potent way to bring yourself inside of your body
and regulate your brain and your nervous system. Some other ideas here for
variety:
* Arm lifts: from standing upright or sitting in the chair with a straight back
and an open chest, raise both of your arms on inhalation and release them in
exhalation – repeat 5-7 times, using breath as a vehicle for
motion.
* Balancing rises: from standing upright, with both of your feet on
the ground, rise to your toes extending your arms out on the inhalation, bring
your heels to the ground and hands to your heart/chest on the exhalation -
repeat 5-7 times, using breath as a vehicle for motion.
* For more one minute movement ideas, visit my YouTube channel at: http://www.youtube.com/c/IrinaDiyankova
Steps 2-4 are
mini practices. Each takes only a minute or two to perform. They can be
used individually and multiple times a day to create a moment of regulation and
a moment of calm. The more frequently you practice, the more resilience you
will create and tap into. There is no need for perfection. If you forget for a
day, a week or a month to do those things, you always have a chance in this
next coming moment to choose to practice one of them.
5.
Clean the slate
Ideally, we will do it every 24 hours. However, when we are in crisis
situations it is not always possible. I suggest that you take a few minutes
before you fall asleep or while you are in the shower to release the day
(previous 48 hours or week). With every exhalation, release pressure, tension,
physical pain, negative thoughts. Ask white light to surround you and bring
safety, love, joy, connection, forgiveness or something else your system
desperately needs in the moment. Extend compassion to yourself.
I would like to
end part 1 of this post with a brief summary. Crisis situations often push us
into survival mode, which can help us deal with life and death. While
it could be useful in a short-term, it really tends to hurt us in a long-term. So, we don’t want to
live and function in this mode. I discussed five different strategies that can
help shift from survival into regular mode of functioning and provide a needed
respite. These strategies are very brief and could be utilized multiple times a
day to create mini breaks for the nervous system, brain, and mind. Using these
practices on a regular basis may also protect us
from a long-term negative impact of acute stress.
culture burdened by a lot of trauma, I received plenty
of messages about struggle being a deviation from the norm. I was told
explicitly and implicitly that if I stumble, it is my fault and I need to find
a way to fix it. Nowhere along the road of my childhood, I have ever heard that
it was OK to struggle and that struggles are a part of life. I did not know that everyone struggles at one point or another. I did not realize that struggles and crisis provide opportunities to grow and develop.
Today when clients
come to see me, they often talk about their desire to stop pain and stop
struggle and they are looking towards therapy to fix whatever might be wrong
and broken inside of them. The truth is neither me nor therapy can do this for
anyone, because we are all broken and beautiful and lovable at the same time.
Moreover, none of us have total or even significant control over our external
circumstances. No one can prevent an accident from happening, loved one dying
from an incurable disease, or a partner being fired from job. We live in the world where injustice, inequality, and prejudice are daily occurrences. Painful and
stressful things happen to us often. And, our modern culture’s
expectation that we can be happy and well at all times in the world that is as
complex and imperfect as ours is simply unrealistic, in my 
