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.
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.
Aside from his political
Comments I enjoyed this video and will
Use some of his tips with my clients. His presentation was clear and simple
I respect his political views but feel our problems are not limited to the Presidency. I see the craziness throughout our govt cuz as divided as our country is and many against our leader it would be an opportune time for the enemy to strike. My fear is bio warfare !!! I would like this virus to unify us. We are all Americans and if you dont agree with the President then use your right to Vote and your voice will be heard. That is the democratic way and what has made our country great thou the years. We need to work together by sharing ideas and respect each to find resolution to stomp out Covid. Not a good time to find fault with each other.
thank you for not deleting bessel’s comment on trump. there is an unmistakeable trauma resulting from this president, and not to acknowledge the effect he is having en masse, is to be in some denial. which would not be helpful to anyone. i posit there is more objectivity to admitting the negative effect on citizens, than will probably be mentioned by anyone who supports him. the trump presidency simultaneous with the virus menace, a double crisis……so glad to see the goodness of people though, it truly is the worst and best of times.
Excellent comments from Bessel!
In a nutshell: movement and rhythm
Movement in relationships (engagement). Body movement, movement through our days (structured tasks)
‘Thanks!
Beatriz
Where do you live? In the United States where we have the amazing President Trump, I feel sorry for you that you are so discouraged about the leadership in your country. Thank you for encouraging me with I at least have a positive President who is helping us see the light at the end of the tunnel. Sharing with my group it is such a great video as always!
You live in a fantasy land Katie. Rump will go down as worst, most corrupt, misinformed, most untruthful and divisive “leader” in our history.
a positive president who calls the virus the asian virus? A president who leads on dividing and spitting racism and sexism. Good luck with this comment!
I think that Bessel has idenfied excellent strategies for our new normal. I already do some of the things he mentioned. That’s partly because I love structure and always try to structure my life and activities. It brings me confidence and takes away doubt.
World wide there is a lack of trust in ALL governments and health services this phenomenon is not related to personal prior opinions about health services of governments. Acceptance of that as a phenomenon can help the feelings of anger.
Important to sit up straigjt as much as possible not slouch! Practice esp when video with clients. Also body posture can both reveal emotional responses and change emotional responses.
Very helpful. Without realizing it, cooking had become my grounding activity, same with my grown children, friends, and clients who enjoy the same home meal plan service.
I agree with the idea of anticipatory grief. I have been able to calm colleagues and clients as we give helpless feelings a name and they link to the universality of pain and loss. I see growing compassion and empowerment as people feel they are not alone in the distress if these times. I witness and experience significant trauma knowing that few leaders on any side of the side will be able to hold a civil conversation to reach acceptable actions and policies to benefit those under their jurisdiction, that people of various groups or philosophies currently unpopular will be villified, insulted, and mocked regularly in Social and public media in the name of what ts right. (Changes every few decades or geographically.)
Thank you! most of the strategies presented I already put in practice spontaneously, and his explanation is encouraging me and makes sense to what I’m doing. That’s what I need most at this time because sometimes I feel myself in the unpredictable pre-trauma situation. Great idea about cooking!
I see the unpredictability he’s discussing as linking into the pain of living, or in Firestone’s Separation theory called death anxiety and existential aloneness. His suggestion is to differentiate from that pain and link up to structures that encourage connection with self (like our bodies in exercise) and others (using phone and video). What’s fascinating about Firestone’s theory near the end of “Ethics of Interpersonal Relationships,” is how a country can be manipulated by fear when people don’t do their own inner work (of coming to terms with this pain of living like death anxiety that the idea of the pandemic evokes). And how the increased fear gives rise to a more charismatic and rigid leader. We need islands of safety and anchors that mirror secure attachment in the leaders in society. That is lacking; Porges in his keynote address on March 19th in the psychotherapy networker, pointed this out. It’s only when people come to terms with their death anxiety and integrate enough to see life beyond a self in survival that we can create the change that is really possible in the world. Lots of us want it and are ready for it, for whatever reason it’s not being reflected in the wider world. This doesn’t effect the power of the vision that I carry and continue to lie inside me. Deep change is possible.
Wonderful! Dr. van der Kolk is the greatest expert on trauma in the world, to my mind. Thank you for your gift. BTW, I’m glad you didn’t “cut it out.”
I have been impressed with his work before but here he sounds simplistic and rigid
Simple is good, just ask Mother Nature
Excellent directives. Appreciate you leaving in political comments as they are, regardless of your preferences, a part of what is happening in this country now. Never thought of using cooking. Thank you!
I am a MFT who has “done the work” and have, for the most part, figured out how to live with calm certitude. I was therefore surprised to find myself feeling free-floating anxiety during this pandemic. And then I realized I was experiencing “ANTICAPATORY GRIEF”. I crunched the numbers and came to the conclusion that I am most certainly going to experience losing someone I know–I just don’t know yet how close that death will come. I am a great admirer of Dr. van der Kolk and appreciate his message. I will apply his points this week with my increasingly anxious clients.
Thanks for this insight and suggestion to create structure and getting small things done, to keep your mind and body going and to keep in touch with others.
Excellent, down to earth video, kindly, and helpfully said by Bessel.
Furthermore, it is stabilizing and encouraging to hear a trustworthy person of wisdom and practice merely say, as it were: The emperor wears no clothes.
Makes me so thankful for the predictability and emotional and ethical integrity of our Prime Minister here in Aotearoa (New Zealand). She feels like a safe and consistent parent. Most people I know can not even begin to fathom how Trump can be defended. I would feel very afraid if he was our leader!
Hi Jacqui – as a psych in Australia i can completely agree with you. We often get news updates about the action taken by your Prime Minister and she is always such a grounding steady force. I wish we took more of a leaf out of the way you guys manage things and not just in relation to Covid19.
I am not a practitioner, yet. But my 80 year old godmother lives alone in a small one room flat 7 time zones away. Having to stay indoors all the time, and with all recreational and social activities suspended, she is getting really restless. I have been asking the government in her country (Singapore) to broadcast mindfulness meditation programs. I am hoping they would do that. I am sure my godmother is not the only one going crazy in her small flat.
I’ve been encouraging clients to do alot of what Dr. Van Der Kolk was saying about organizing time, feeling grounded and staying in touch with family and friends.
This was very helpful, thank you!
Thank you so much for posting this, for helping us focus on what is helpful in helping our clients and also ourselves. I had been telling my clients some of this already, but now I can improve the way I articulate it and make sure I am emphasizing the important things. Very much appreciated!!
I absolutely agree with the position of this great scientist.
Our incompetent and reactionary leaders contribute to increasing our insecurity and fear!
I appreciate the simplicity of encouraging our clients to get back to, or create routines in order for them to have and develop a sound sense of control of the things they can control. Thanks for your thoughts.
Oh my gosh! I am so happy that BVK decided to leave in all of his comments. I personally have lost all ability to trust my government, especially now when nonpartisan leadership is needed so desperately and there’s none to be found. Though my husband and I are in the highest risk category, my deepest trauma is coming from the feeling that the inmates are running the aslyum.
Thank you for this brief but right-on-topic presentation. While I agree that it is important to unite peoples, communities and country, as well as the humanity of our world, I welcome the forthright honesty of the doctor. When our country has a president who does everything he can to divide us, e.g., narcissistic rallies, governors pitted against one another, etc., our responses in my opinion must challenge his bizarre intentions, particularly when it comes to the physical, mental and emotional health and well-being of others. I unquestionably have been feeling the tension of both the unpredictability of the virus and the unpredictability of the leader, anxiety on top of anxiety. Dr. van der Kolk eased my compounded angst. Again, thank you.
As feminists have recognized for decades, “the personal is political.” And, from my perspective as a clinical social worker/ systems thinker, Bessel is not being political; he is describing reality. For those of you who follow everything he says but find his statement about the President offensive, please think again.
I appreciate that NICABM published this with what their disclaimer seems to indicate is a “controversial” segment, but the disclaimer is a disappointment. This would have been an opportunity to take an honorable and healthy stand, along with the world’s foremost expert in trauma. How much would that have “cost “ you? As a mental health community we have an obligation to speak the truth and provide guidance for the whole person within their environment.
Thank you, I agree!
The personal is political, but the political is not always therapeutic. No one said Bessel’s statement is offensive, btw.
Agree completely!
I was hoping to share this video but will not do so because of the political commentary. I actually believe that the regularity of the president’s Covid-19 Task Force daily press conferences, besides being informative, is regulating and even comforting for those in the country who are not predisposed to despise him. That is why, I believe, they are so widely watched and why 60% of those polled approve of the president’s handling of the crisis, including many independents and even some democrats. Those who watch (and are not automatically triggered by the mere sight of him) likely see, despite his flaws, a leader who is genuinely trying to make public health decisions with the respected input of his sycientific advisors and take protective actions for the American people, including economically. I respect Dr van der Kolk greatly; please consider posting an edited version of his video.
I have no problem hearing Bessel’s comment, or yours for that matter. I would just like to have the opportunity to share the video without it. I serve a population that is predominantly politically left and who have largely felt traumatized since the president was elected. I keep my own views to myself and work respectfully and empathically with those with whom I disagree, accepting their perspective without pathologizing them as I hope you would do with outside of this forum. Obviously, there are millions of people who find some value from the press conferences, and you might want to consider that they are not all suffering from maladaptive defense mechanisms. As I suggested, I would not recommend the conferences to someone who is predisposed to despising or being triggered by anything Trump, but there just may be those out there who think differently than you and your clients in Vermont without having to be “in denial.” If you have not already done so, as an exercise, you may want to consider watching a press conference all the way through, rather than just the edited snippets placed on the news, imagining how it would be perceived by someone who does not share your biases.
You are certainly making some assumptions about me here. How do you know that I have not watched an entire conference and how do you know that I haven’t been intimate with and perhaps lived with others with very different perspectives? And, although you apparently read what I said, from your response, I don’t think you understand what I said. I am a feminist and a clinical social worker so that I work with clients in the context of their relationships and environment; I most certainly would discuss the state of our state as part of the problem. And, let me add that I have been doing this for over 45 years so I think I prefer to take my cues from Bessel, as opposed to an “Anonymous” poster.
Excellent advice!! So simple and obvious yet profound in it’s wisdom. I was doing it unconscious of its relation to agency. Even downplayed its importance in my mind but the effects are the way to cope well.
Thank you.
Toni Stevens Ph.D
Thank you for this information. I deal with clients remotely and have been encouraging them to keep in touch with family and friends by video or Skype. On a personal level I have been able to facetime my son who has Covid-19 and in isolation. For both of us it had been so important.
Ailsa Smith, Scotland
Wishing your son a speedy and full recovery.
Thank you for not editing this post.
Thank you for leaving the comment about our dangerous and narcissistic president in the video. His policies and inaction have caused more harm than good.
Let us be kind and care for each other through this crisis. We can be the voices of calm and reason in the storm.
Trish Donaldson, Owners Manual Therapy, Denver
I absolutely agree and commend you for your insights re: our leader. How can a nation undergoing this much trauma be able to hold our collective seats when we hear the president ruminating and sowing uncertainty and divisiveness? We need a leader who operates with a clear and loving message.
Absolutely – give yourself a structure; do something regularly; ideally, do some aerobic exercise 30-45 minutes, 3 or 4 times per week. It is absolutely the best anti-depressant, anti-anxiety, stress-buster on the planet and it doesn’t come in a foil-blister pack. Aerobic exercise burns off stress hormones and generates endorphins (happy hormones). If you are stuck inside, put on an exercise video; run up and down stairs; dust-off the old exercise bike; do press-ups, tummy bends, etc. until your body is glowing and until you need to have a shower; then – most importantly – lie down for 15-20 mins. This helps to bring your autonomic nervous system more back into balance. Then have something light to eat. (Don’t eat when you are stressed; you’ll give yourself IBS). Mark up the kitchen calendar, with a red star, every time you do a workout.
Give yourself a weekly Task List – 3 or 4 little things that you have been meaning to do or that you have had a whisp of a fancy to do: fix that wonky shelf; sort out everything in that drawer; phone a friend and ‘blether’ a little; write an email to so-and-so asking how they are; stick a nice picture in the window so passers-by can see it; little things – but doing them gives you a sense of agency. Doing things that make you feel better, lifts your self-esteem. Mark the kitchen calendar with a purple star once you have completed your little Task List.
It’s coming into spring in the northern hemisphere, so if your lucky enough to have a garden, no problems: there’s your task list and possibly your aerobic exercise all in one package. Maybe, you know someone who is a little bit ageing and struggles to exercise their dog or do their garden: be neighbourly. They can watch you doing it and they get pleasure and so do you: just keep out of their house, so as they are not at risk. If you’re going for a walk, take a plastic bag with you and collect any litter that you see. You are helping the environment, getting exercise, and improving your sense of agency and self-esteem. Often doing lots of little things like this can be more rewarding than doing one big thing. Become your own agent! “This can be your mission, should you choose to accept it.”
I found the video to be quite validating and helpful. Thank you for leaving in the political point of view.
I agree with your comments. And, it’s about knowing your client and naming/ normalizing the trauma now triggers and impacts their personal trauma- present and past. This could be an opportunity to address their unique trauma tending.
We all want the best for our clients and each other. I say this without any criticism just another perspective. Thank you.
Thank you for normalizing the crazy political stance of our country. Just as a chaotic external life mirrors a chaotic internal life for an individual. Bessel named the chaotic president is a reflection of our nation as a whole, chaotic, unpredictable collective.
I appreciate the emphasis on creating a predictable structure of the day, which I was suggesting but this provides even more reasons to do so. Thank you.
I’ve been doing this with my clients all day as a central strategy and goal of this time to cope and have been finding folks are showing some extraordinary resilience in the face of these events and been very grateful for the support if our discussions. As a side benefit to me, I go home having reiterated multiple times daily the agency that was so beneficial that I’ve found a general pleasure myself in coming home from a long day of work at the hospital to a simpler time at home myself.
Very helpful. Do wish the political comment would have been deleted. Otherwise very helpful.
I really appreciate Dr. Bessel and his research and insight. However, I am disappointed that you would leave his political view in the video. This is a time for us to come together. I do believe the responsible action would be to omit that part of the video. Politics in itself can be anxiety-producing and traumatic for some.
I agree. Honor that many may find the president very calming amongst the chaotic ‘other’ politicians and particularly news casters.
I think this is a time, for many of us, to reappraise values. To realise what is really important to our lives.
Finding new meaning and purpose has the potential to change many for the better.
Discover, grasp and consolidate.
Thanks so much for this. Very helpful
Thank you, very helpful and informative
Thank you, this has been very useful, I am aware that I am in a privileged position where I have space and resources and the opportunity to be connected, supported and able to support others albeit remotely. I am also concerned about the very many people who are not only isolated but are unable to access any support; spiritual, moral, financial or material. This is indeed a very strange time we are living in and as referenced to by Bessel in the US, there are major similarities in the UK, Europe and possibly the rest of the world. My experience is that people have been very caring at a local level my hope is that it takes on a more Global stance and that we all take more notice of the amazing Greta!
Great job. All these strategies are amazing so simple yet so effective and do able
Another excellent talk and encouragement by Bessel. I have gotten out my cookbooks and have made some incredibly tasty, nourishing soups and froze some of them. They’re better than any carton soups you buy! Thank you!
Thanks for these reminders, especially about helplessness. Also, I relate to the idea that in some ways institutions have become ‘mothers’ to some and as the institutio struggles with the next step, its members are traumatized by the lack of predictability. I will certainly share. One of my concerns though is for those who will be plunged (or plunged further) into poverty by this virus. They may not have meals to cook and anxiety is heightened re feeding their families. I suppose as trauma therapists we work to help them find safety as in connecting them to resources and helping them identify their inner resource or safe space. I would love to hear more about work with those clients we have. Thanks again!
A great video at this time. Thanks ?
Because you do not agree with his assessment, does not justify calling his “morality and values” into question. Many, many, many people, most assuredly our front line workers, are feeling the agony of the “political virus” to which he speaks. This disease is a significant component of the trauma people are feeling, and the inconsistencies and lack of solid leadership certainly fueling feelings of helplessness.
I already have PTSD and a fulltime job which is my sanctuary, and even though my job is secure, I feel insecure and feel my myself slipping where I just want to hide away in my bed to shelter myself from all this talk everywhere. I work in a hospital and it seems amplified. I’m trying my hardest to bring other things into my day to distract from falling in a heap.
Thank you for the reminder and advice, I have a plan to make one of my favourite meals tonight, my husband is away working and I feel very lonely.
Katrina – you are absolutely amazing! Please give yourself 5 Gold Stars *****. Despite your PTSD and – God knows that is hard enough to live with – you are doing a full-time job – and you are working in a high-risk environment and doing essential work in this crisis. So – you are doing more for yourself and for everyone than many of us who are stuck at home, or feeling helpless. Please also take care of yourself – the Golden Rule of Being a Carer. I am sooo glad you are making one of your favourite meals: I hope you enjoy it; and maybe you can share the recipe with us!
So concise and helpful – I’m working with our troops and I will be promoting creating agency through our own predictability. And Bravo for addressing that this is on top of the current political situation. Our environment and our democracy is being threatened as never before. Ok next thing on my schedule… wishing you all creativity and kindness.
Yes, creating anything predictable such as a new daily schedule with fixed times is a good way to put predictability in our lives when the world is no longer so. I love most the idea of fixing yourself a nice meal (self-care) and FaceTime a friend who is doing likewise and enjoy a meal ‘together.’ A mood enhancer to ‘be’ in this way w a friend while doing nice things for yourself!
Good advice, especially the need to move the body through yoga or some other physical activity. Also my instinct is to only do resourcing & grounding with clients at the moment & not to go into any past traumas. Trump obviously fits the criteria for Narcissistic Personality Disorder so why are Bessel’s comments even remotely contentious?