When most people think about trauma, they think about unexpected, usually awful, events that occur within a defined time frame. Very fast traumas can be instant, such as getting hit by lightning, or a head on collision. Fast traumas include being the victim of violent crime or being in a fire. During fast traumas, our bodies and minds experience a rapid and dramatic shift in function. This is sometimes called the “flight/fright/fight” response and corresponds to rapid sympathetic nervous system arousal. This prepares us to rapidly exit a threatening situation, or to overpower a predator, where escape is not possible. Slow traumas occur when the traumatic event occurs over a long, potentially infinite, period of time. Examples are loss of limb, imprisonment and poverty. The COVID-19 pandemic is an example of a slow trauma. In situations of slow trauma, the “flight/fright/fight” response is of no use. There is nowhere to go and no one to overpower. This article will focus on coping mechanisms that are effective in situations of slow trauma.
Coping with fast trauma is facilitated by the sympathetic nervous system arousal. Increased levels of adrenalin and cortisol increase our athletic stamina, sharpen our awareness of our environment, and enhance healing of injuries. This heightened state of arousal is designed to be used to flee from predators, dangerous situations or to fight when one is unable to escape. Once the trauma is ended, either by escape or by neutralization, then healing can begin and growth can resume. The “flight/fight/fright” response is generally not helpful with slow trauma, but it usually happens anyway, and is often unproductive. In traumatic situations where one can neither escape nor fight, the surge of adrenalin associated with the body’s alarm response, turns into anxiety, Because there is no tangible threat or target, the nervous system activation tends to come in waves, rather than rapid and strong onset, as with fast trauma. These waves of stimulation can escalate to panic-like states that are often associated with immobilization. This is sometimes referred to as “deer-in-the headlights” reaction, which leaves the individual defenseless. This is an absence of coping skills and ability.
Coping with slow trauma requires overriding the fast trauma response in favor of more adaptive responses. This is an application of Kahneman’s concept of “thinking, fast and slow” (Kahneman, 2011). Traumatic situations are by definition imminently threatening or harmful. If you cannot escape or overpower the source of the trauma, then you must make adjustments to be able to live with the trauma as long as necessary, perhaps forever. The following steps will be helpful in coping with slow trauma, like COVID-19.
Accept that the trauma is here to stay. Waiting for a slow trauma to pass is a form of immobilization. It is a form of disempowerment and encourages feelings of helplessness and associated increase in anxiety. This is not coping. Coping requires that you prepare for change and then make these changes when it is adaptive to do so. You may have to find new ways to get food, or to live. You may have to move. You may have to find different employment. You may get sick. You must prepare yourself to be flexible, mobile. To be able to deal with as many possibilities as you can.
You must first focus on survival. You must secure short-term access to the basics for survival: food, water, shelter, communications, etc.
Things are not “going back to normal”. Disaster is part of evolution and the world continues to evolve. You must evolve with it. Look at the trauma as a reset, an opportunity to make significant changes that benefit you or others. Be prepared to change your business/work as well as your family circumstances so that they can survive and function under new circumstances. Telecommuting, take out dining, telehealth are examples of adaptions to the COVID-19 slow trauma.
Take breaks when you can. Rapid adaptation is exhausting. You need to not only rest your body, but also rest your mind. Reading, exercising, watching a movie, are all ways of resting your mind. Thought and introspection benefit adaption, but rumination will increase anxiety and decrease functionality and efficiency. Introspection involves exploring new ways of looking at problems and supports solving them. Rumination is going over the same thoughts over and over again and only increases anxiety.
Prepare to be flexible. This means understand that you will make errors. If you are afraid to make errors you may become immobilized. COVID-19 has caused us all to find new ways to live, work and socialize. These new ways will be unfamiliar, as you have never been in this situation before. No one has.
Help others after you help yourself. Once you have secured your own survival you will be best situated to help others and it will benefit you to do so, Helping others works against immobilization and feeling helpless.
Mixed Fast and Slow Trauma
Traumatic events often have both fast and slow components. For example, on September 11, 2001 over 3000 individuals died within an hour when the world trade center was attacked by terrorists. Individuals in lower Manhattan that day experienced a fast trauma: those who were not killed by the impact of the airplanes on the buildings had to escape the area before the buildings fell on them and before they were enveloped in debris and dust. The flight/fight/fright response facilitate running as far away from the terror scene as quickly as possible in order to survive the day. Once having done so we spent the next several years adapting to a city that was identified on that day as a terror target. The flight/fight/fright response was no longer useful and turned into anxiety. We had to get used to being screened by bomb-sniffing dogs and we learned to report suspicious activities to authorities. We added metal detectors to public sites such as airports and courts. We are still adapting.
Few individuals get to go through their natural life without trauma. Some survive stronger. Some survive scarred. Some survive broken. Some don’t survive. This article discussed three common human responses to trauma.
The flight/fight/fright response which is helpful for fast trauma but cumbersome for slow trauma.
Adaptation of oneself to long term/permanent changes in the environment or in life circumstances.
Immobilization which does not help facilitate coping with traumas of any types.
The ability to use the fast thinking flight/fight/fright response and the slow thinking adaptation response and the ability to know when to use each one of them, may determine whether or not you survive a traumatic event. We are naturally equipped to cope with both fast and slow trauma, but we must apply these abilities selectively.
REFERENCES:
Kahneman, Daniel. (2011). Thinking Fast and Slow. Farrar, and Giroux, New York City.