Long before the DSM — the Diagnostic Statistical Manual of Mental Disorders — included PTSD, or Post-Traumatic Stress Disorder, in its 1980 edition, much had been written about soldiers returning from WWI having what was then referred to as “shell-shock.” Soldiers returned from the front in rags, starving, fearful of a surprise touch and, especially, loud noises. Visual memories were equally as activating. Talk to anyone who fought in Vietnam or Cambodia, where no amount of assistance has succeeded in shaking them of their vivid memories.
PTSD is not a new phenomenon. There are reports as far back as 3,000 years ago, written by researchers Walid-Abdul-Hamid and Jamie-Hacker-Hughes in their report “Nothing New Under the Sun: Post-Traumatic Stress Disorders in the Ancient World.” But one does not need to be a soldier to present with PTSD. Our current COVID frontline workers are experiencing this in droves.
According to the American Psychiatric Association, Post-Traumatic Stress Disorder is described as “a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.” They describe the symptoms as follows:
“People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached or estranged from other people. People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or an accidental touch.”
Nurses, doctors, hospital orderlies, and EMTs have reached their limit. They are now seeking therapy and tell me they cannot continue at this pace, and often cannot face yet another person who is going to die no matter what they do to help. They are suffering from nightmares and day-mares where they try to give the hopeless some hope, including themselves. We are one year into this pandemic and many of our nurses and doctors have been on COVID watch from day one. I have often had to encourage the most courageous of these workers to take a much-avoided medical leave of absence when they are not at their professional best and find they are at their emotional worst. They become useless to the very people they are trying to help.
Many in my profession have had to draw the line, as well. It is easy to hit the wall after 10-12 hours a day working with clients presenting with severe anxiety, depression, or COVID-fear psychological paralysis. Therapists are adept at assisting others in setting personal boundaries and protecting burnout, emotional fatigue, or psychological stress, yet not so good at doing it for themselves. Now, many therapists have joined the ranks of the exhausted and overwhelmed. It is emotionally wearing to hold close the fears of others. Those in the profession understand that many of us cannot let go at the end of the day; we take it on and take it with us.
I have often used humor as a big part of my therapy, helping clients find the lighter side of their issues, finding elements of the day worth a chuckle, finding joy where they thought there was none. It has become almost impossible to find much to laugh about as we wait impatiently for the vaccines, for work to reopen, or, most important, for the chance to see and actually hug a loved one. Therapists are often cheerleaders for their clients, shaking the pom poms at all possibilities of hope. Our job is to provide clients with the ability to see the light, not just the darkness, of this pandemic and find their own way forward. Our world is now all about baby steps, not giant leaps. We need to remind our clients, and ourselves, that the future promises to be brighter. Often, we need to remind many that there is a future. There is. My professional moniker has always been “Shift Happens.” It does, and it will again.
Susan Winston, LMFT, is a psychotherapist with a practice in Great Barrington and Los Angeles.