As Enrique Parada explains in his manual on psychology and emergencies, there are some factors that aggravate the perception that we have that a situation may be more or less stressful and, therefore, susceptible to the creation of a traumatic imprint.
These factors are the following:
- The extreme modification of a habitual situation.
- The uncertainty generated by this new situation.
- The fact of being able or not to predict the consequences of the situation.
- The ambiguity of the accessible information
- The imminence of the consequences
- The duration of the situation
- The perceived intensity of the situation
In the case of the COVID-19 crisis, several of these characteristics that aggravate or intensify the perception of stress are present. Depending on this perception, on the history or biography of the person and on the different responses that can be put in place to alleviate the consequences of the exposure, the experience of this crisis can be disintegrated, creating a traumatic memory.
The presence of recurrent nightmares or the uncontrolled onset of intrusive and dysregulatory thoughts are signs that clearly indicate that the person is experiencing serious adaptive difficulties.
How to diagnose post-traumatic stress disorder
One of the essential criteria for the diagnosis of post-traumatic stress disorder is the perception of serious threat to life in the triggering event. In the coronavirus pandemic, there has been a proliferation of news and cases with serious consequences for the survival of sick people, creating an aura of lethality around the disease that directly results in the impression that being exposed to the coronavirus is synonymous with death or very serious illness.
Different types of responses
Faced with this situation, people may react by showing different types of responses. Some of these will be adaptive and serve to relieve pressure and distress. On the other hand, others will be reactive to the situation that has to be resolved or addressed, all of them sustained for a short period of time and aimed at preserving the integrity of the person.
We can also observe totally dysfunctional, maladaptive behaviors, which are still an attempt to address or cope with the situation we are facing, some of these responses would be panic, shock, denial of reality and therefore increasing the risk of exposure to stimuli that provoke the stress response.
There is an essential component for coping with emergency situations or stressful situations. This is the locus or locus of control. We make an attribution of everything around us and this attribution generates a greater or lesser sense of control over the situation.
The greater the sense of control we have, the more predictable the situation seems to us and, therefore, the lesser the consequences of exposure to stressful stimuli or potentially harmful situations. This is what we know as internal locus of control.
However, many people perceive that what is happening to them is totally out of control, so their sense of discomfort increases. In this type of situation, it is very useful to take measures to generate habits that make us feel control and predictability over the situation.
Post-traumatic stress in healthcare personnel
Healthcare personnel on the front line of the pandemic are exposed to many of the characteristics that define a situation as potentially harmful. Most of the symptoms and signs of such damage do not appear immediately, but will appear when they can stop, when they can rest. Precisely in the more relaxed moments of de-escalation, these professionals will be able to experience part of what they have experienced, in the form of bodily sensations of uneasiness, thoughts of hopelessness, intrusive images, nightmares.
Whether this is a temporary situation will depend to a large extent on whether these professionals have been able to maintain spaces for self-care and for the emotional management of their experiences.
What is the most appropriate treatment?
In the case of recurrent presentation of these difficulties, to the point that they represent an impact on family, social or professional life, it will be advisable to initiate a desensitization treatment and processing of traumatic memories. It will be necessary to be able to establish a new narrative that will allow the health professional to explain himself and feel good in his professional performance in the face of the health emergency situation.
The therapeutic procedures of choice for this adaptive difficulty are the following: cognitive therapies, emotional psychoeducation and EMDR therapies. The latter have proven their worth in the treatment and recovery of acute traumatic experiences, called simple trauma, to the point of becoming the treatment of choice recommended by the APA (American Psychological Association) for the treatment of post-traumatic stress disorder (PTSD).
Although hospitals have specific resources available, these are often saturated and usually propose group interventions due to the high demand, so that they are losing effectiveness and potential for preventing the onset of complications. In the case of experiencing the symptoms described above, it is important to immediately consult a psychological professional with training in PTSD or emergency and disaster treatment techniques.