Rationale: Sometimes it helps to talk about trauma; sometimes it helps to just listen. Having a safe, supportive, confidential, affirming environment to do both or either is important.

Background: I have been offering workshops on “managing stress and avoiding burnout” for years. I have always acknowledged the importance of yoga and other complimentary, often behavioral, strategies for stress management. Exercise, hobbies, socializing, pets, good diet, and anything else that works for people is fine. Our hurried, impatient, impulsive, self-centered ways have been encouraged and supported by the “quick fix” approach to just about everything, including healing and health care.

However, “quick fixes” do not have long-lasting effects.

My workshops add the importance of understanding our own often unconscious transferences, or patterns in thinking, feeling, reacting, and behaving. Then we can use these patterns to get ourselves unstuck, manage stress, and avoid burnout. Research shows the effectiveness of including these deeper aspects of experience, making it possible to change our feelings, reactions, thoughts, and behaviors.

Current reality: We are now way beyond “managing stress and avoiding burnout.” Beyond any preexisting individual trauma, we are now in deep collective traumatic distress. Yoga, and even understanding our transferences, is probably not enough for us to cope.

Sure this will all help, but the widespread trauma and reactions need a deeper, more thorough attention. Depression and anxiety continue to emerge. People have increased physical symptoms. We need to understand, but not tolerate, the unacceptable behavior, risk-taking, refusals to cooperate with guidance, excuses, irresponsibility, disrespect, and other ways people express their trauma (because they have not yet learned a better way to do it), that we see.

Although these are all normal expectable reactions to trauma, it does not mean that they are OK, healthy, or should be allowed to continue. Intervention and change are required.

Physicians and other front line responders: Physicians and others on the front line having been treated with disrespect for years, have stepped up to provide care under extraordinary, dangerous, demanding circumstances without adequate PPE or personnel backup.

This unreasonableness has its own kind of stress. Those caring for or otherwise working with the public need ways of managing and coping with the reactions of others, whom we are often trying to help while managing our own reactions.

We may have feelings that are new to us or newly intense. We may feel a range of feelings that we never have felt before, including distress, grief, anger, frustration, impatience, anxiety, panic, despair, tension, stress, helplessness, hopelessness, failure, self-deprecation, inadequacy, overwhelmed, disbelief, or any other feelings, all of which are normal. Letting feelings see the light of day through discussion or just listening, rather than festering and being relegated to the depths of the unconscious, helps coping.

Implications: Trauma has some common aspects for everyone, but we each experience and express its devastation in our own unique way. We feel its impact in different ways, at different times: immediately, months, years, or decades later.

At some point, we will be past even the spikes in COVD-10, and most of us will be vaccinated. However, even then, it will not be over. Collectively, we do not have the knowledge or the skills to deal with the long-term effects — never mind the relatively short-term effects of trauma.

Trying to bury trauma does not work. It rears its head later in various forms. We have no real understanding of the impact of trauma or what that even means, and that it often causes PTSD, or what that means. One fact is certain: We cannot cope alone or in isolation.

Conclusion: We have a long, difficult, painful road ahead of us. Sometimes it helps to talk about it; sometimes it helps to just listen. Having a safe, supportive, confidential, affirming environment to do both or either is important. I have been offering my physician colleagues and their staffs the opportunity to do so via Zoom, for no fee. It’s the least I can do.

Peggy A. Rothbaum is a psychologist and can be reached at her self-titled site, Dr. Peggy Rothbaum.  She is the author of I Have Been Talking with Your Doctor: Fifty doctors talk about the healthcare crisis and the doctor-patient relationship.

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