Emotional Health

A Therapist’s Views on the Pandemic:
Trauma and Battle Fatigue

Jane Moffett, PhD is a psychotherapist specializing in the treatment of trauma and traumatic loss. Earlier this year, in the Spring, she participated in a webinar for the Rhode Island Episcopal Clergy addressing concerns about the coronavirus pandemic and offering insights into how we can help those in need. While we mourn the loss of so many, within our country and around the world, this pandemic has also plunged us into a period of economic devastation with millions of unemployed Americans facing homelessness and hunger. Compounding the trauma is the uncertainty of the upcoming presidential election: both the process and the outcome. And, as the Black Lives Matter movement continues to call out racial injustice and the need for radical change in our nation, we simultaneously must grapple with the disproportionate loss of life and the increased risks Covid-19 has on Black Americans. Many of us are at a loss of how to deal with these compounding traumas.

Last Monday, WVFC presented the first of  Dr. Moffett’s three-part series, Adapting to Changes in our Work and Personal Lives. This week, in Trauma and Battle Fatigue, Dr. Moffett writes, “During the pandemic, there may be days when you find yourself overwhelmed and weary from bringing your full self to the people you care for.” She helps us understand why it is important to pay attention to those emotions and offers ways to cope with common difficulties and symptoms of “battle fatigue.” She unpacks the fight response in times of fear and loss, the effects of hypervigilance on anxiety, sleep, and alcohol consumption, and how feelings of detachment or hopelessness can be a manifestation of dissociation. Finally, Dr. Moffetts reminds us, “When we work through fatigue, and push down our own feelings in the service of helping, we turn down the volume on our internal life. . . and on our joy and happiness.” 

I understand that these posts may cause anxiety for some of you. It is normal to want to have a lovely summer and many may want to avoid more talk of the pandemic, the economic crisis, and the many other issues that American citizens are dealing with. If these posts are too much at this moment, save them for another time. No one really knows what to say or how to write about these painful experiences in a way that will resonate for everyone. We hope that you recognize that we at WVFC are making our best effort to be part of a national conversation — one that will help us collectively find a way forward. 

We welcome and are thankful for Dr. Moffett’s contribution to WVFC during this unprecedented time in American history. Next week, Dr. Moffett will share, A Pandemic Self-Care Tool Kit. 

Dr. Pat 

 

 

Trauma and Battle Fatigue

By JANE MOFFETT, LCSW-R, PH.D., S.E.P

 

The Fight Response at a Time of Fear and Loss

Fear is a normal and necessary survival response to danger. We are living with fear in our battle with Covid-19.  Many of us are fearful about catching the virus and have disquieting thoughts about death. We are living with the loss of the world as we know it. Many are also uncertain about the financial future. These feelings can fuel an underlying sense of helplessness. Anger and outrage can counteract helpless feelings. For some, it is empowering to feel angry. 

People in these states of anger or rage are prone to “trauma brain.” Trauma brain is black and white thinking: either it is this or that. Either I have control of the information, or it will all fall apart. This kind black and white thinking also leads to ultimatums like: either he or she apologizes, or I quit. Sometimes you can diffuse things by pointing out that while things seem black and white, there may be more gray in the situation (or even a third way).

 

The Fight Response and Domestic Violence 

Domestic Violence is a manifestation of the fight response gone deadly. If you suspect someone is the victim of domestic violence, it is important to ask. Quite often the person will deny it. It is most often a woman, but there are men who are abused. The Domestic Abuse hotline is 1-800-494-8100. Often, someone in an abusive relationship feels trapped and will not or cannot leave the home immediately, but experts advise they be prepared by keeping, near the front door, a hidden bag containing: money, identification, keys, and a phone or phone numbers. 

 

Hypervigilance

Hypervigilance is linked to all three responses, flight, flight, and freeze.  On a cognitive, somatic or physical level, hypervigilance may continue through the day as a sort of low buzz of apprehension or a heightened sense of anxiety. This is a common response to any kind of trauma. Essentially our nervous system does not relax after the initial disruption, but stays alert to danger.  

Hypervigilance is a common problem now, and one contributing to sleep problems and increased alcohol use. We want to relax, but a part of our brain is still looking for danger. There is nothing on the news that reassures us that this is over, or that there is a clear medical treatment should we become infected, or that a vaccine is around the corner to prevent infection. 

 

Dissociation

Dissociation is also a reaction to trauma—usually a chronic stressor. We want to watch for this with frontline workers who can pass a threshold of tolerance for death, and may be physically exhausted from being sick themselves with Covid-19. 

Psychotherapists are also seeing mild to moderate forms of dissociation in people who have been isolated without adequate support.  It is one thing for people to feel demoralized and weary. But if you are experiencing detachment that has a numb or hopeless feeling to it, it may be a manifestation of dissociation.

For some people,  the heightened vulnerability of what they are experiencing with the pandemic can push them into a kind of emotional cold storage—dissociative state, which is deadening. 

 

Pandemic “Battle Fatigue”

During the pandemic, there may be days when you find yourself overwhelmed and weary from bringing your full self to the people you care for. The belief  that we should be able to manage (no matter what), has as its  underpinning  in the belief that if we are not coping, or if we are experiencing pandemic battle fatigue,  it is  due to a character flaw, a moral failing, or a shortcoming of faith. But even strong people need time out to refuel emotionally, physically, physically, and spiritually.  When we work through fatigue, and push down our own feelings in the service of helping, we turn down the volume on our internal life. 

Further, conscientious people are especially at risk for overriding what we are experiencing on an emotional, physical or somatic level in order to meet the needs of others. One of the risks of overriding what we are experiencing—because there is so much to be done—, is to leave us out of touch with ourselves and therefore more at risk for acting out those feelings by lashing out (fight,  detaching (flight) or shutting  down (freeze).  It is one of the paradoxes of caring and wanting to help, in that if we care too much, try too hard, we may end up in a depleted state.

We cannot turn down the volume on our internal life selectively. If we stop listening to signals that we are frustrated, sad, apprehensive, exhausted, or resentful, we also turn down the volume on our joy and happiness. It is these positive emotions that replenish our emotional reserves. If we turn down the volume on one set of emotions, we turn down the volume all together. 

These painful states leave us vulnerable to self-medicating with food, alcohol, or drugs. Setting the bar too high, or minimizing our pain, hurt, fatigue, or fear  may literally leave  us with a pain in the neck from too long at the computer,  a hungry heart without some time connecting with people dear to us, a quick temper, or sadness and buried resentment—all of which contribute to burn-out. 

 

Next week, Dr. Moffett will expand on the importance of having the support of loved ones and practicing self-care. 

 

 

 

Join the conversation

This site uses Akismet to reduce spam. Learn how your comment data is processed.

  • Mickey monroe August 10, 2020 at 11:10 am

    Thank you all so very much for these timely well written words. Thank you.

    Reply