When the COVID-19 Pandemic Leaves Us Feeling Helpless

For most patients, the COVID-19 crisis has created a “new normal.” They may be stuck at home, unable to work, or feeling isolated from dear friends and family.

This all can leave people feeling helpless.

So what can we do to help patients regain a sense of agency during the pandemic? Bessel van der Kolk, MD has several ideas.

Take a moment now to hear them in the video below.

Just one note before you watch: there’s a section that Bessel specifically asked us to leave in, even though we’d normally remove it. However, this time he wanted you to be able to hear it for yourself.

Click here for full transcript

Being in a situation where you can not do what you always do, where you’re basically rendered helpless, that’s the definition of trauma. The definition of trauma is being unable to do anything to change the situation. So we’re all living under a pretty traumatic cloud right now of we don’t know what’s going to happen and we don’t know what we can do very well about how to control it. So the only thing that we can control is our own reactions. So now, the big job becomes how we get locked up at home and help ourselves to become calm, and have a sense of agency? To my mind, a very important thing is the issue of structure. Anybody who runs a job, anybody who runs a monastery, anybody who runs a kindergarten knows how important structure is, that you start something at a certain moment and you stop something at a certain moment, and the issue of time becomes very important. When you’re traumatized, you live in a timeless sense of helplessness. Once you start dividing up the day in times and say, “At eight o’clock in the morning, I’m going to cook eggs and make myself breakfast. At 10 o’clock in the morning, I’m going to do some yoga for 25 minutes. At 11 o’clock in the morning, I’m going to call my aunts, and my mother, and my best friend,” and that becomes my schedule. “At noontime, I’m going to make that lunch for myself and I’m going to be on the internet with a friend who’s also eating and I’m going to have a lunchtime conversation.” And so, beginning to organize your day in things that you can do and you can organize, very much focused on your own internal capacity to do things to organize your life. When you’re dissociated, when you’re frozen, the whole sense of time disappears, the sense of agency disappears, and that is of course what we are afraid will happen to so many people who are there, who are in this current state, who are falling back on the state of timeless, helplessness or horror. It’s very serious. The issue of boundaries, the issues of expectations, the issue of predictability, the world outside of us is completely unpredictable. We have a President who is crazy. Let’s face it, don’t cut this out. It’s important. We have a virus that’s a medical virus and we ever have a political virus and these both are terrible things to deal with. This is all about the COVID-19 and our political situation, which are contaminated by each other. And I bet you’re going to cut this out, but you shouldn’t because trauma is about predictability and trust. And so you get traumatized as a kid if you cannot trust your parents. If your parents become unpredictable, if you don’t know who your parents will be from one moment to the next. As a mental health professional, it’s very important to be very predictable, to have a very clear structure. And to know we start at that time and we are finished at that time and only for us to structure our therapy, to structure our days, because unpredictability is at a root of trauma. So we are all right now with the COVID-19 virus in a pre-traumatic state because life is unpredictable. The one thing we can do about external unpredictability is to make our own life predictable and to some degree to become boring, to really say, “Every morning at nine o’clock I will do a yoga class or I do a dance class or I’ll do something to move my butt.” Because the other thing that is really about trauma is immobility. If you sit on your butt all day, you will increase the sense of helplessness in your body. So you need to do something and you need to schedule physical activity where you actually move your body and feel the strength of your buddy. This is a good time to do weightlifting, to do pushups, to get out the old manuals about how to Marine Corps train people. You need to move your body and feel the sense of strength and agency in your body. Get your cookbooks out, start cooking, and follow the rules of your cooking and to see what you can produce. Again, get a sense of agency back into your body in that I can make a delicious meal even though I have nobody to eat it with. I will eat this meal and I’ll call up a friend who has done the same thing and we’ll eat our meal together and we’ll tell each other what we have cooked and what is the best thing about our recipe. We need to organize our interior lives because our exterior structure has disappeared. That is very simple good trauma therapy.

According to Bessel, there are insights we can draw from trauma therapy that could help patients when they’re feeling helpless or reeling from the unpredictability of life during a pandemic.

Now think of the patients you’ll be seeing this week. Is there a strategy from the video that one of them might find particularly helpful?

We understand that not everyone will agree with Bessel’s politics, and we appreciate that we have a community of practitioners from both sides of the aisle. But for the comments we’d like to focus on what we all have in common: our work with patients.

Please let us know a strategy that one of your patients may find helpful in the comments below.

189 Comments

Ian Macnaughton, Psychotherapy says

Appreciating the call to Agency and capacity to do “something”, anything that challenges the status quo of immobility in our current context, I will be noticing where clients are being creative in their structuring the process of their days just a bit more from vessels message.

Mary Allard, Social Work, USA says

This is so important, to help educate our clients on how they can “experience the feeling of strength in their bodies.” Developing mobility vs immobility, and making that the familiar state of comfort, for healing to begin.

Thomasina Bates, Counseling, GB says

Great, thank you, sound advice.

Annette Ladowitz, Social Work, Saratoga, CA, USA says

Fantastic !!! Simple, clear, doable. Needs no Ph.D to understand and use. Sharing with my Ph.D, LCSW friends and normal family and friends. We can all use this wisdom. Thank you for helping us cope with this difficult abnormal time in history.

Patricia Stewart, Counseling, AU says

What Bessel is saying, and suggesting, is exactly what has supported and allowed me to recover (combined with much long term counceling and extremely valuable art therapy) from a lifetime of living with the consequences of childhood neglect and abuse (combined with my mother’s Munchausen Syndrome) which expressed itself in a dysfunctional core personality based in/on Complex PTSD. I am now eighty three and live a creative, interesting and healthy life. No one says it ‘exactly’ how it is like Bessell!!!!! Recovery is never too late. but, one has to work hard for it. Thank you to all who did their best to help me, when we crossed paths. P/Sx

- Karen Copsham, Social Work, GB says
  
  Brilliant to read your post. Thank you for sharing – helpful to me!!
  
Marilyn Jean, Social Work, Portland, ME, USA says

I love listening to Dr. Van der Kolk! He gives it straight, yes, and as he does so, his point becomes quite clear in regard to the effects of trauma. I take no offense at his comments about what is helping to fuel unpredictability in the midst of COVID 19.I like his ideas for personally creating predictability while being isolated for an unknown period of time. I will be sharing this video.

Laurie Bowles, Another Field, Fishers, IN, USA says

Very biased and unprofessional. Regardless of politics, adds to feeling of fear and helplessness. Shame Bessell put his (smirking) self-gratification over professionalism and just as sad that it was not deleted.

- Marilyn Jean, Social Work, Portland, ME, USA says
  
  As you said, “regardless of politics”… This period of unrest in the midst of a new/unknown pathogen which has led to this pandemic, does indeed create feelings of helplessness due to its unpredictability. Dr. Van der Kolk is straightforward, with no pretentiousness regarding what may be “professional,” in the eyes of some people. He clearly demonstrates the down-to-earth communication style that many people can identify with, thus earning the trust of patients. Assisting clients in a manner which places their needs ahead of all the letters after his name is a gift, and providers who can do that are demonstrating true “professionalism.” I admire that.
  
michelle pritchard, Nursing, GB says

i think maybe the setting of a timed structure like getting up and having breakfast then maybe doing 30 mins of exercise i am going to try this this week by setting up a daily activities chart for them

MK Phillip, Social Work, Fresno , CA, USA says

I applaud your saying the C word in regards to the leadership in the federal government. As a mental health practitioner with 48 years of experience, I believe it is past time for us as a profession to stop standing by and thinking that matters will improve without an accurate diagnosis and appropriate treatment intervention. The question is how to make it happen. We will be a sicker society staying in denial.
Thank you for your ideas on how to bring sanity back for ourselves, our clients, and loved ones.

Ray Stella, Counseling, USA says

No one is empowered by pretending that madness is sanity. Let’s just call it what it is. Many people are being actively traumatized by the endless gaslighting, abuse and insanity coming directly from the president.

Anonymous says

true

J.M Emetchi, Psychotherapy, Portland, OR, USA says

J.M. Emetchi – trauma worker.
In my mind it is false to separate Trumpian politics from this COVID-19. Brown and black people, poor people financially, Immigrants, Elderly folk and others disproportionately are impacted and the impact is far worsened by the appallingly slow, ridiculously conditional and stingy response from Government. Trump’s decisions hold some responsibility for Americans sickening and dying. Politics and health care are entwined and we helpers in whatever form we give ourselves need to realize this and quit denying that there is a vicious Class war happening here. To not comprehend this is to be naive and apply a “one size fits all” approach to the huge diversity of situations that happen every day and every night.
Bravo Bessel I stand alongside you.

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