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Christine Forte May 14, 2020

Counseling in a time of COVID-19: The Past is Present

An important part of therapeutic work is becoming more aware of the sources of emotional reactions: are they entirely oriented around present situations or are there some roots in past experiences? This awareness is important to being able to gain perspective, coping and healing. As we’ve already seen from our clients and communities, in the last two months of social distancing, the emotional impacts of COVID-19 can hit different people in different ways. For those of our clients experiencing more severe stress during this time, it’s important for us to be aware of the ways that past traumas can be impacting their present reactions.

For some clients this may have already been on our radar and a part of the treatment plan; COVID-19 just brings another layer to our work. But others may have believed the past to be in the past; finished. However, the advent of COVID-19 and all the changes it has caused in our lives can have triggered old hurts in new ways.  

 A number of elements about social distancing and the illness itself can be linked into these new feelings, not least of which are the understandable anxieties about getting the disease, or the frustrations with how daily life has been limited. But it can be useful for us as counselors to be prepared for how it might affect those with history of trauma:

Fears about safety in public

Hypervigilance or difficulty feeling safe in public spaces are common manifestations of post traumatic stress. These can be exacerbated right now by the knowledge that the possibility of virus transmission means that being in public places carries greater risks than it normally would. The way one client explained this feeling to me was that before the current crisis she had been able to work on her fears of being in crowded places by understanding that this was a symptom of the trauma she had been through. But now, with stay at home orders, she felt that her fears were essentially verified by authorities, that in fact, it is not safe to go out. And while temporarily it may not be, working through the emotions that these situation brings up, particularly for when it’s time to go back out, is an important part of healing in therapy.  

Feelings of Losing Control

Many elements of life feel out of control right now. All of us can experience days where we feel the rug is continually get pulled out from under us. While this can be upsetting and frustrating, to those who have been through trauma, these daily losses of control can feel more like complete groundlessness than just a temporary loss of footing.

Reactions to Confinement

Feeling frightened by confinement is a specific way that fears around losing control can manifest. Depending on the type of trauma someone went through, feeling that they don’t have the option to leave an environment when they want to to can be particularly stressful.  

Healthcare Anxiety

For those who have experienced trauma either from their own medical treatment or that of those close to them, the current heightened awareness around illness can be triggering during this time, especially in hearing detailed descriptions of medical issues or seeing images of those in hospitals or in PPE.

Social Anxiety

Managing in social situations is an area that can be challenging for some survivors of trauma. There can be echoes of the past in wondering if one will be good enough or will be rejected or criticized. Currently, most socializing is at a distance, through social media or video calls, making it that much easier to over-perceive being slighted. It is also possible that those we are socializing with will be experiencing stress of their own and therefore either express something in a way that is hasty or unkind, or respond in an unexpected way. It can then be challenging for the trauma survivor to have the perspective to give the benefit of the doubt where needed or to not take this personally.

Fears or Reactions to Conflict

In a similar vein, when past trauma is being triggered, people often react more strongly in situations of conflict than they usually would. They may become suddenly very passive, flee the scene or fight back harder than the situation merits. Again, the changes in life related to the pandemic can have a compounding effect, making all of these reactions stronger. Particularly in situations where people may be experiencing conflict with someone that they are staying at home with, they can feel that they have no options to be able to get away from that person for a while, making it hard to calm down and gain needed perspective on the conflict. Or, in a situation where someone perceives that another has broken a social distancing rule, they may also react very strongly, as their warning bells about safety may be ringing even more strongly.

Building Resources and Connections

These are just a few triggers which I’ve come across; for sure there are more. In becoming aware of these, as always in working with our clients on trauma, we want to help them in accessing and building internal resources, without in any way discounting their experiences. They are not wrong for feeling how they do, emotions are never wrong, we just want to help with decreasing distress so that they are able to function in their lives.  

When traumatic reactions are triggered in the brain and we begin to experience high levels of panic or anxiety, we are no longer able to think clearly or respond well to situations as they arise. However valid our fear may be, when trauma or panic are coming up, we often aren’t in a position to take care of ourselves as needed.

For many of us, not just our clients but all of us as human beings, social connection is such an important part of coping. Right now, this connection can be challenged not only by social distancing but by echoes of traumatic or stressful experiences in the past. Wherever we can, helping our clients to feel emotionally connected, not only to us but to the people in their lives who they can trust, can be a further important element of coping with trauma and healing.
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Christine Forte is a counselor working in private practice online with the globally mobile community. She has recently repatriated to the US with her family after ten years of living and working in Shanghai, China. You can contact her at Christine(at)forteklotz.com or read more about her practice at www.forteklotz.com

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