Still Scared After All These Years: Traumatic Stress Reactivated in a Time of Global Crisis
Jana Pressley, Psy.D. & Joseph Spinazzola, Ph.D.
The Foundation Trust
Guide de ressources en français
Current events often generate and exacerbate stress, especially in our age of the 24-hour news cycle and social media saturation. Whenever we log on, link in, or even turn on an old-fashioned television, we run the risk of becoming overwhelmed by the seemingly endless exposure to violence, financial uncertainty, and incivility. And now, overshadowing all of that is the Coronavirus (COVID-19) pandemic. As we all find ourselves contending with this serious global health crisis, there may be some among us who are feeling especially vulnerable to anxiety: those with a history of complex trauma.
Complex Trauma: How the Past is Relevant in the Present
Complex trauma exposure comes in many forms including but not limited to experiencing childhood neglect or abuse; witnessing or experiencing domestic or community violence; enduring lifelong racial, cultural, religious or gendered oppression; and growing up in chaotic, unpredictable living situations in which our caregivers struggled with serious mental health issues, substance abuse, or health crises.
For adults and youth alike, those among us with histories of chronic childhood trauma tend to struggle with ongoing internal experiences of anxiety or panic that can be easily triggered in the present. For those who were constantly navigating adversity in their early years, it is common that the body’s stress response system was activated frequently, and at a level beyond the capacity that the autonomic nervous system was designed to manage on a day-to-day basis. We now know from decades of research on complex trauma, neurobiology, and adverse childhood experiences (ACES) that a chronically elevated stress response is correlated with long term negative health consequences, and also is often connected to risky health behaviors such as substance use, problem eating and self-harm. As troubling and at times dangerous as some of these risk behaviors can be, they are often best understood as survival-based adaptations to complex trauma that evolved to help a person disappear in the face of inescapable violence or abuse, quell intense emotional distress, or obtain relief from chronic numbness.
As children, trauma-impacted individuals often learned to navigate physical and psychological danger by being highly attuned to the mood or stress level in their immediate surroundings: their homes, neighborhoods and schools. This is known as hypervigilance, and it is a powerful instinct that supports survival in the midst of threat. If a child detected danger in his early environment, perhaps he adapted by learning to read the emotional climate of caregivers and interact in a way that kept the peace. For another youth, perhaps she had to fight to protect herself; or become invisible; or become numb to the fear and helplessness.
Fast Forward to the Present
This same hypervigilance often lives on in the body for years beyond the initial trauma exposure. Essentially, the stress response system gets “stuck” in a survival-based state of alertness. Often without the conscious awareness of our minds, our bodies can react to triggers reminiscent of past traumatic experiences such as a loud and startling sound; the fear of feeling trapped; or a facial expression that looks threatening or rejecting. In these instances, we can suddenly find ourselves transported momentarily to the past and thrust into a state of panic.
This can occur without a clear understanding of why it is happening or what specifically set it off. In other words, as an adult a current situation can trigger emotions or memories from an earlier time. When this happens, the old internal sensations associated with these past traumatic situations kick in. In times of current stress, when most everyone around us is feeling justifiably concerned, worried, or upset, complex trauma survivors can become paralyzed or beset by more intense psychological responses. We can find ourselves feeling helpless or frozen like a terrified child or behaving in an impulsive and reckless manner like an enraged or distressed youth. When our alarm response gets triggered too often, it can engender or worsen persistent mental health systems and contribute to problems with our relationships, vocation, and overall functioning.
Some of the ways an individual with a complex trauma history may already experience the world (prior to a global crisis) might include:
- My body feels tense or painful
- My emotions are hard to understand or regulate, and extremely difficult to articulate
- My mind is reeling with fears, worries, self-doubts
- The world feels unsafe, unpredictable
- People can be hard to trust
- It is difficult to ask for help/support
- I have a hard time not feeling alone
- The world is functioning around/without me
When a present-day threat emerges, all the above feelings, thoughts, and fears tend to intensify.
Connecting the Dots Between Past and Present
In the current state of uncertainty in our world, it helps to be aware that historical experience can be triggered in a manner that can heighten present day reactions. While an entire community might be feeling anxiety in response to a global crisis like COVID-19, a complex trauma survivor might experience intensified reactions to particular details that are most pertinent to their own life stories. Someone with a history of food insecurity might feel particularly panicked when confronting empty shelves at the grocery store. Someone who experienced emotional deprivation or neglect as a child might feel extremely anxious at the idea of social distancing in general. And someone with a history of sexual abuse in the home might feel panicked and trapped if required to sequester for an extended period.
Given the resilience of the human spirit and the various ways in which healing occurs, many individuals with a history of childhood trauma have found joy and fulfillment in life. Therapy, family and community support, spirituality and prayer have served as powerful aids for many individuals who have experienced trauma. For most complex trauma survivors, however, there are still particular scenarios that can take us by surprise and stir up old, familiar feelings or sensations related to our past. Another common characteristic of complex trauma is that it often leaves individuals coping with a sense of constant unpredictability and loss of control. Past experiences of helplessness or powerlessness associated with chronic trauma can carry into the present day and be triggered during times when our surrounding environment or larger culture is experiencing threats to safety or disruptions to daily life routines.
During these challenging times, all of us need a caring community and routines that support self-care and sustain health. Particularly for those of us with a history of complex trauma, it can be helpful to recognize the ways in which the past might be overlapping with the present, intensifying an already unsettling or frightening environment. Even when there are variables out of our direct control in a larger societal crisis, it can be extremely useful to find tangible daily practices to manage anxiety. When we are able to pause and be curious about our internal responses, we can better understand, soothe, and seek support for our needs, while also being sensitive to those around us.
Resource Ideas and Anxiety Management Strategies for Complex Trauma Survivors Facing Acute Stress
Everyone is different as far as what feels most helpful during a triggered moment or period of distress. What follows is a list of ideas and suggestions that might help someone create moments of re-centering and calming. We recommend that you consider gently experimenting with these or other coping techniques to find the ones that work best for you.
- Build a daily routine that helps support a sense of predictability and control.
- Maintain connection with your community. If you are feeling isolated from friends and loved ones, schedule daily or weekly video, phone, or text chats with people who bring you joy and comfort.
- Incorporate closeness and safe physical touch as a comforting element of daily life. Curl up with a pillow, blanket, or favorite stuffed animal; or, if it’s an option available to you, snuggle with a pet, child, or partner in your home.
- Consider building a simple mindfulness practice into your day, such as deep breathing, meditation, stretching/yoga, or guided imagery. There are many good apps to guide these practices (e.g. Headspace; Calm; Stop, Think, & Breathe).
- Whenever permissible, step outside to take some deep breaths of fresh air, take a walk or bike ride, or do gardening or yardwork.
- Assess whether your body needs sensory input that brings your energy up or down. Sometimes when we are distressed, our energy feels too high (hyperarousal) and needs to be soothed, while other times our energy leaves us feeling shut down, withdrawn, and numb (hypoarousal).
Tending to sensory needs can include activities such as drinking hot tea or a cold drink, taking a warm bath, wrapping in a heavy or weighted blanket, or using scented lotions, candles, or essential oils. Additionally, materials like playdoh, putty, sand, or fidget toys can be useful.
- Consider movement and exercise, particularly if feeling disempowered. Stretching, engaging in brief vigorous exercise, or strength training can assist the body in feeling stronger and more regulated. Sometimes simply shifting the body from a vulnerable position into a more powerful, active stance can adjust our physiology in a positive manner.
- If you are feeling particularly triggered by a memory or emotion connected to past trauma, engage in thoughts or activities that ground you to the present. Grounding is a strategy that connects us to the present moment. Use your senses to focus on what you can see, hear, touch, smell, or taste in the moment as a reminder that panic/fear from past experiences is not happening in the present.
- Identify personal sources of positivity, inspiration, comfort, and joy, and build these into your daily routine. Read, listen to, or watch stories that inspire you, make you laugh, nurture your spirituality, or remind you of your core values. Listen to music that lifts your spirits. Whether you play an instrument or just pull out some pots and ladles, consider making music, dancing in your kitchen, or engaging in other rhythmic movement.
- Consider
creating things that bring you satisfaction. Baking, painting, drawing, sewing, writing, collaging, and making photo albums and scrapbooks are all examples of creative tasks that can feel both calming and fruitful.
- For the non-artists amongst us, combat rumination and corral wandering anxiety by redirecting your thoughts and getting absorbed in light but focused problem-solving activities such as jigsaw puzzles, crosswords, Sudoku, or computer chess.
- Limit news and media input. Especially if you are feeling overwhelmed by news overload, and yet compelled to keep up to date, set intentional limits on your own news and social media intake, with reasonable intervals to “check in” on latest news and updates. For example, consider limiting yourself to checking for news update to three time per day for not more than 15 or 20 minutes, and avoid falling down the rabbit hole of associated social media threads.
- If you are getting triggered by family members’ or friends’ messages or social media posts filled with strong reactions to the latest dire reports, consider restricting certain material from coming into your social media feed. Or let the heavy media disseminators and commentators in your life know that you are currently feeling overwhelmed and kindly request to not be included in their information loop.
- Finally, remind yourself that asking for help is important. Identify the people in your life who would be accepting and supportive if you reached out in need or for solace,
encouragement, or non-judgmental listening. Contact a trusted friend, family member, mentor, physician, therapist, or spiritual leader in your community. In return, on days when you are feeling on surer footing, consider opening yourself up to serving as that emotional support resource for important others in your life.
A printer-friendly PDF of this resource is available to read and download in English, Spanish and French
Guide de ressources en français
For children and adolescents with a history of complex trauma and their caregivers, we recommend that you review the list of coping strategies in our companion resource guide for youth: Coronavirus (COVID-19) Pandemic Coping Strategies for Youth with a History of Complex Trauma, also available in Spanish, French, and Portuguese.
A companion resource for seniors living with chronic conditions and the people caring for them is also available: In This Together: Helping Seniors Living with Chronic Conditions to Maintain Connections in Times of Isolation
References*
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Sprague, C., …van der Kolk, B., (2007). Complex trauma in children and adolescents. Focal Point, 21(1), 4-8.
Grossman, F., Spinazzola, J., Zucker, M., & Hopper, E. (2017). Treating adult survivors of childhood emotional abuse and neglect: A new framework. American Journal of Orthopsychiatry, 87(1), 86-93.
Hopper, E., Grossman, F., Spinazzola, J., & Zucker, M. (2018). Treating adult survivors of childhood emotional abuse and neglect: Component-based psychotherapy. New York, NY: Guilford Press.
Pressley, J., & Spinazzola, J. (2018). The developmental consequences of exposure to complex trauma in childhood and adolescence. In J. Osofksy & B. McAlister Groves (Eds.), Violence and trauma in the lives of children (Vol 1.). Santa Barbara, CA: Praeger.
Pressley, J., & Spinazzola, J. (2015). Beyond survival: Application of a complex trauma treatment model in the Christian context. Journal of Psychology & Theology, 43(1), 8-22.
Rhodes, A., Spinazzola, J., & van der Kolk, B. (2016). Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study. Journal of Alternative & Complementary Medicine, 22(3), 189-196.
Spinazzola, J., Habib, M., Blaustein, M., Knoverek, A., Kisiel, C., Stolbach, B., Abramovitz, R., Kagan, R., Lanktree, C., & Maze, J. (2017). What is Complex Trauma? A resource guide for youth and those who care about them. National Child Traumatic Stress Network.
*Several of these articles can be downloaded from the Resources section of this website for free.