During the pandemic, mental hygiene is just as important as hand washing. It’s time to disinfect your thoughts and kill the ANTs to overcome anxiety, depression, trauma, and grief. ANT is an acronym for —Automatic Negative Thoughts. Daniel G Amen, MD 2020Over one year into the pandemic while only 50 % of the US population is currently vaccinated with at least the first shot, we are seeing the importance of mental health in managing the pandemic. It is now abundantly clear, that it is because of mental health underpinnings, that the next wave of the pandemic is building. People cannot remain in isolation forever. The indefinite duration of confinement grew insurmountable to enforce and the collective civility toward social distancing and mask wearing became politically untenable for many governors. People need to socialize, be free to worship, attend weddigs and funerals, even dance in the streets, as we have seen Americans do ever since it “reopened” when state governor’s decried the pandemic under control. And we have paid the price for this. Mental health tends to be the ugly step-child of physical illness in a society that is strongly biased against the emotionally infirm in favor of the medical model of well-being. For one thing, alcohol sales increased 200 percent among Americans coping with loneliness and frustration while in quarantine. There is no doubt that people felt the stress of being cooped up during the first weeks of the pandemic. The quarantine put a strain on sensible behavior and emotional credulity over social distancing, all the while putting ANTs in our heads. In places like India and across Europe where the vaccine roll out has been less successful the infection rate has risen, and given the propagation of variants that have been reported, those who are not yet vaccinated have much to fear. Michael Sefton
It has been frequently mentioned that exposure to death and uncivilized brutality has an impact on wellness and personal resilience. Not a surprise. Especially in these pages, I make an effort to point out that the cumulative impact of traumatic exposure slowly whittles away one’s capacity for mental health, empathy and emotional efficacy. “There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.” (Dillon, Johnstone, & Longden, 2012). The conundrum has always come down to just what constitutes a “traumatic” event in childhood? Sometimes there is no single identifiable event that a child brings forth that may later become a trigger of serious emotional instability later in adulthood.
The Covid-19 virus has the potential for creating traumatic events depending upon the degree of exposure and a child’s understanding of the narrative brought forth by parents and other trusted adults during the pandemic. “Over 30 percent of Americans know someone who has died or been infected by the virus. The fallout to mental health from the coronavirus is real. I see it in my own family as nerves become frayed 8 weeks on.” according to the blog post from May, 2020. Trauma informed therapy supports the model of early traumatic experience being the underpinning of many mental health outcomes we see later in life. The biopsychosocoial model identifies physical abuse, sexual abuse, exposure to violence, chronic substance abuse as the substantive reasons for many mental and physical illnesses years later. When we look in the rear view mirror at this virus we will see the litter of emotional wreckage that may leave its hooks in many people around the globe.
There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.(Dillon, Johnstone, & Longden, 2012).
“The more adverse events a person is exposed to in childhood, the greater the impact on physical and mental health and well-being, with poor outcomes including early death” (Anda, Butchart, Felitti, & Brown, 2010; Anda et al., 2006; Felitti et al., 1998). There was a time in my training that I collected data on childhood fire setting and the psychodynamics of pyromania. I saw 50 children in my fellowship year who came because of fire setting. Without a doubt, there was marked early instability in the childhood homes in these kids that likely germinated into fascination with fire play and perhaps more directly, physically aggressive behavior. Many of the children I assessed were suffering from early onset trauma.
Depending upon the age of onset using fire as an expression of internalized conflict suggests a serious emotional disorder in need of expert assessment and treatment. The interest in fire may appear normal but slowly interest foments in homes where a prevailing emotional vacuum permits – decreased emotional warmth, access to fire starting materials, an absent parent, and frequent domestic violence.
The inconsistent and unpredictable exposure to violence contributes to excessive and unpredictable behavior as children become adults. Often without direct knowledge of a specific trigger, trauma activates brain circuits that drive fear and emotional behavior including substance abuse, domestic violence, and assault. What is more, these absorb community resources as psychological needs grow.
The coronavirus has profound impact on the emotional stability of people around the world because of its unpredictability and lethality. It evokes fear, and uncertainty as it spreads unchecked. Later, the virus can serve to trigger long hidden memories in a way that can sabotage healthy human development leading to vague anxiety, physical symptoms, loss, and deep despair.
Scott D. Jones of Arlington, MA was a decorated paramedic who responded to a mass homicide in 2000 in which 7 people were shot in an episode of workplace violence. He would go on to kill his second wife and 2 children 14 years after repeated episodes of severe depression and suicidal behavior and domestic violence toward his first wife. These behaviors were the first red flags of an impending emotional breakdown and terminal rage. Paramedic Jones certainly had problems but the repeated exposure to trauma – especially the mass shooting, activated his fight-flight response intolerably and may have been one of the demons he faced in the end.Michael Sefton, Ph.D.
Trauma can be triggered by loss due to Coronavirus in two ways. First, by direct contact with a family member who is hospitalized and may have died. Nearly every person who contracted the virus had someone left behind that was worried about their health and eventual recovery. Many had family members who communicated with patient via text messaging and FaceTime – until the loved one could no longer do so. Families relied on the updating calls of first responder nurses, chaplains, social workers, and physicians.
Next, through secondary exposure to similar cases and media coverage that assails efforts at closure and engrains the narrative of fear, guilt and shame by reporting ever increasing case numbers, hospitalizations and deaths survivors are left feeling numb and unable to mourn. Funerals were deferred or could not be held at all as some jurisdictions required the cremation of the remains of coronavirus victims. This has a negative impact on survivor health and well-being often evoking a religious and moral crisis of faith. Survivors have enormous guilt and sadness not being with a loved one who died from the virus or waiting to go for medical at the onset of symptoms. They mourn to mourn and are left feeling numb at the lack of closure.
So whether it is early trauma associated with domestic violence or trauma from repeated exposure to work-related experiences, there is a resilience that resides within most people that guides the rise from being overwhelmed again and again to move forward with courage and hope and feelings of hardiness. These are learned responses to high stress events like a pandemic, but people who are positive thinkers, optimistic, physically fit and emotionally insightful rise up, controlling the lives they lead.
We are offering a zoom platform event entitled The Psychological Impact of the Cornavirus Pandemic: Common sense answers on November 11, 2020 at 5:30 EDT and again in December 10, 2020 at 7 PM. It is free and to be sent the zoom link contact: firstname.lastname@example.org or call the Whittier Rehabiltation Hospital at 508-870-2222 in the U.S. If you plan on attending the 12/10/2020 session please drop me an email at: email@example.com
Michael Sefton, Ph.D.