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Understanding & Responding to the Trauma of the Covid-19 Crisis

The Fight Against the Covid-19 Virus

The world is presently battling the devastating impact and on-going danger posed by the Corona Virus / (Covid19 Virus). This is a global traumatic event, which many of us have not witnessed in our live time. During such an event, we are confronted with a direct or potential threat to our life, safety or wellbeing. The stress, fear, anxiety and shock, which is experienced is extremely unsettling and can potentially overwhelm our ability to cope. This can harm us physically, emotionally or psychologically, impacting our mental health, as well leading to difficulties in every day functioning

What is the Clear and Present Danger?

We are no strangers to traumatic events such as, natural disasters, involvement or exposure to warfare, bombings, shootings, murder, suicide, sudden death, extreme isolation, robbery, actual and threatened sexual or physical violence, harassment, bullying, as well as organisational changes like mass restructuring and redundancy. However, the significance of this present threat, is its indiscriminate and global scale. This has caused immense social, political, financial, physical and mental upheaval due to a virus, from which no one is immune. Our ability to manage and overcome, such a traumatic experience depends on how well we understand its impact, along with our ability to respond adequately and constructively

How are People Reacting to the Corona Virus (Covid-19 Virus Crisis?

The Trauma inflicted by the Corona Virus (Covid-19 Virus) is being experienced over a prolonged period of time, with an increasingly dire effect. We see how Individuals have reacted differently. The range of these responses is normal and is to be expected.  It is also natural that our survival instinct of the fight or flight response is triggered, exposing our strong reactions of fear, anxiety and uncertainly. Other typical reactions include; confusion, anger, aggression, disorientation, tearfulness and feeling helpless

During this on-going critical period, as well as up to four weeks following this crisis, reactions can include:

  • Nightmares
  • Flashbacks, reliving the experience
  • Recurrent thoughts about the trauma
  • Avoidance of places and things which represent reminders of the incident
  • Difficulties with concentration, memory, thought process
  • feelings of guilt, and a sense of disbelief
  • Depression, anxiety, mood swings, anger, denial, feeling of numbness, irritability, sense of insecurity,
  • Problems sleeping, eating, tiredness
  • Headaches, nausea, dizziness
  • Withdrawal and isolation

Reactions, such as these are likely to be prominent, in those who have suffered the loss of loved ones, cared for the sick and dying, lost their homes, jobs or businesses or have otherwise been profoundly impacted by this experience  

Again, it is important to recognise and acknowledge that these symptoms are a natural response to an unusual occurrence. In order to recover, individuals require time to process the experience. This enables them to work through, manage and make sense of what has happened, allowing them to feel better and return to their previous state. At the end of the crisis most people will usually see a decrease in these symptoms over a space of two to four weeks. However, the on-going impact and severe far reaching effects of this crisis can lead to extended difficulties, which are likely to require a longer recovery time  

Post-Traumatic Stress Disorder

Increased symptoms for more than four weeks following crisis can lead to a number of specific symptoms that could indicate the presence of post-traumatic stress disorder (PTSD) requiring clinical intervention or professional support. Notably, the symptoms of PTSD can start immediately or after a delay of weeks or months, but usually within six months of the traumatic event

The clinical definition of PTSD relates to the occurrence of the following criteria:

A psychological condition that occurs after “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror”.

ESTSS from DSM IV*.DSM V American Psychological Society

PTSD symptoms include:

  • Intrusive reactions: recurrent involuntary thoughts & feelings, nightmares and flashbacks;
  • Avoidance of trauma associated stimuli, such as people, places, discussions, objects & situations;
  • Cognitive and emotional disruption: memory loss, negative thinking and feelings, detachment, decreased: mood, interest & interaction;
  • Changes in arousal & reactivity: irritability / aggression, hypervigilance, difficulties in concentration & sleep, extreme agitation / startled response, destructive behaviour such as unhealthy drug / alcohol use;
  • Significant deterioration in usual functioning e.g. disruption in daily social and occupational activities.

For individuals experiencing mild PTSD symptoms for less than four weeks, a period of ‘watchful waiting’ is recommended, with a follow-up after one month. This approach is used when symptoms are likely to resolve by themselves, with self-monitoring or assessment by a medical professional helping to determine whether there is a need for further clinical treatment or intervention.

What Should Employers and Managers Look Out For?

In the course of the Corona Virus / (Covid-19 Virus) there has been a severe psychological impact on workers, along with a major disruption in the working practice of many organisations. Employers and managers will be the first port of call in dealing with the situation. Therefore, it is important that they recognise and understand the possible impact of this event

There are a number of signs that employers and managers should acknowledge, in order to provide appropriate support:

  • Anger and irritability possibly leading to arguments or conflicts
  • Confusion & lack of orientation
  • Failures in communication
  • Reduced work performance, due to temporary memory and concentration difficulties
  • Feeling tearful, insecure & nervous
  • A change in work atmosphere and mood of employees
  • Avoiding certain areas or tasks
  • Requests for time off
  • Demonstrating significant difficulties over a prolonged period of six weeks or more

Ten Effective Coping Strategies in Dealing with the Trauma of the Corona Virus / (Covid-19 Virus) Crisis

A traumatic event, like the one we are now facing, can be likened to experiencing a severe shock to your core sense of being, both physically and psychologically. Such an experience takes time to comprehend, adjust and recover from its impact. To enable this, there are some positive steps that individuals can take:

  1. Build Resilience: Engage in activities which reinforce mental and physical resilience, as well as reduce stress and anxiety. For example: relaxation exercises, sport and physical exercise, listening to music, reading, fun and games, hobbies, adequate sleep, healthy diet and nutrition, watching movies and connecting with family and friends
  2. Self-Care: Take Care of Your Mental Well-Well-Being, along with those around you through monitoring changes in mood, stress and mental health status. Be aware of when you are pushing yourself past your limits and take regular breaks and time off
  3. Gain support: Talk and connect with people and professionals, who can support you to deal positively with your mental health and concerns. Sharing what is going on in your head can be a great relief
  4. Cultivate a Constructive Perspective: Consider ways you can learn from your experience. Practice gratitude and appreciation promoting an increased sense of wellbeing. Recognise that crises pass and that there are many other important things, which are going on in your life
  5. Limit Exposure to Media: Avoid continually consuming news or talking about the crisis. If you are seeking information gain relevant details from reputable and trustworthy sources (once a day)
  6. Stick to a Plan: Try to maintain a regular daily structure and routine. Set clear boundaries and realistic expectations, which help keep you focused and limit disappointment
  7. Connect & Communicate: Establish regular communication between team members. Get together for remote chats, meetings, sharing ideas and team building. This will provide support, help to lift mood and keep you connected and
  8. Build Family & Social Relationships: Spend quality time with family members. Check in regularly on loved ones, neighbours and those close to you. This can foster a strong sense of community, connectedness and support, which can ease anxiety and fears
  9. Avoid Major Decisions: During a crisis emotion is high, thinking can be unclear and your judgements could be compromised. You may blame yourself, feel guilt, shame or fear and believe that you should be stronger and should pull yourself together. Whilst these are normal reactions, they can be self-defeating. Allow yourself to acknowledge whatever you are feeling or thinking and then be proactive in considering what you need to move forward
  10. Stay Safe & Reduce Risk:  The threat of the Corona Virus / (Covid-19 Virus) means that is vital for everyone to follow medical and official self- care and safety advice

Helping Employees to Recover and Return to Business

The support, which is made available to employees, is essential for their treatment, recovery and on-going wellbeing. There are a number of effective ways for employers and managers to engage and offer constructive support

  • Clearly acknowledge that an unusual and traumatic event has taken place and that time and support is likely to be required. This will help the employee to deal with the situation and return to normal practice.
  • Show empathy and understanding for those affected: listen without judgement and avoid making assumptions, ask open questions, including how are things going at the moment, what would be helpful for you right now and who would help you to feel safer or calmer?
  • Wherever possible maintain as normal a routine and structure as possible, making reasonable allowances for those impacted by the incident. The present crisis has also shown how essential it is to be flexible and adapt to needs the situation
  • Identify support options for the employees, for example, enabling them to take a break or continue with their work, or seeking medical attention.
  • Provide information on the symptom’s employees may expect following a traumatic event, including details on how to seek support. This can be in the form of a leaflet, intranet or your employee assistance programme contact details
  • Differentiate between what needs immediate attention and what is important. Initiate a plan and clear steps to address urgent issues
  • Establish a clear Critical Incident Response Procedure (CIRP), which includes defined roles, action plans and communication processes. Train relevant staff in the CIRP and provide channels for feedback, review and adaptation.
  • Maintain professional boundaries and be aware of your own needs and limitations.
  • Seek advice and support from other teams and departments in your organisation, such as occupational health, human resources or your EAP provider. As well as from government and health organisations
Author: Caroline Ribeiro-Nelson Date: 25/04/2020
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