Anniversary Reaction to COVID-19: What Every Professional Needs to Know

Authors
J. Kevin Cameron, M.Sc., R.S.W., B.C.E.T.S., B.C.S.C.R.
Board Certified Expert in Traumatic Stress
Diplomate, American Academy of Experts in Traumatic Stress
Executive Director, North American Center for Threat Assessment and Trauma Response

Bonnie Randall, Consultant and National Trainer, NACTATR


The first case of COVID-19 diagnosed in Canada was on January 25th, 2020. One year later media headlines on January 25th, 2021 emphasized it has been a whole year since that occasion as if it was a moment of awe. But the country was probably in more of a state of denial than awe in early 2020.

In our work in trauma response we heed the phrase that ‘trauma is stored in the body at the cellular level’ which means that the conscious brain can try to deny the impact of profound loss or trauma but the body always remembers. With that theme, in both the Traumatic Event Systems (TES™) Model and the Violence Threat Risk Assessment (VTRA™) Model we have identified five key “Critical Periods” defined as “predictable timeframes for increased symptom development” for those impacted by trauma. These are intensified when an entire human system is exposed to the same traumatic experience: in this case, a worldwide pandemic! They are as follows:

First Critical Period:
First two weeks post-traumatic incident or loss.

Second Critical Period:
The lead-up to the Christmas/Holidays in December.

Third Critical Period:
Anniversary reactions.

Fourth Critical Period:
When current traumatic events from elsewhere remind of us of past trauma because of similarities between our and their experience.

Fifth Critical Period:
Triggers unique to our own experiences that have been encoded as traumatic stimuli or neutral traumatic stimuli like a sight, sound, smell or touch.
*For our purposes in this E-Alert, Critical Periods One and Three are referenced.

What many professionals do not realize is that for whatever reason, the body remembers anniversaries: specifically the time of traumatic encoding. And that time was not when the first case was announced it was when we went into quarantine for the first time. For some it was March 15th, for others the 16th or the 17th but for all it was mid-March when it was clear we were all doing something we had never done before: really go our separate ways.

As noted in the earlier publication, “Family Dynamics During the Pandemic: The Closeness-Distance Cycle” (Link) what was about to happen in some homes during quarantine was going to be more traumatic than the fear of the virus (not including the tragic loss of life to Covid that has occurred).

There is no doubt many, like myself, believed that surely in the modern era we would not still be in this a year later. Belief, hope and then hopelessness for some has followed those early days and while some are trying to “just get through it one day at a time” others are feeling that “this mountain is insurmountable”. Those feelings are often intensified during the lead up to the first-year anniversary. However, those who do not understand where the feelings are coming from may feel a profound lack of hope. Children and adults alike can have this experience but once they understand it, they can begin to gain mastery through knowledge of the human condition. Understanding why we feel the way we do brings our lives more in control while feeling without understanding leaves us lacking control and missing the one essential ingredient necessary for recovery from trauma: HOPE!

My colleague Bonnie Randall has shared her expertise in the following “Cheat-Sheet” to assist in the understanding of the brain-body connection during COVID with a special emphasis on the lead up to the 1st Year Anniversary and how to manage it.

Self-Care & Stability:
A Cheat-Sheet For Well-Being Within the Critical Periods Of The Pandemic
The term ‘Self-Care’, too often colloquially distilled into superfluous notions such as spa dates or massages, has a crucial and scientifically supported place within how to cope most effectively with the pandemic and its upcoming critical period—the First Year Anniversary .

Note first, that the immersion into the intensity of the Pandemic has impacted brain architecture. Facing and re-facing traumatic stimuli has kept the brain in a chronic stages of reactivity. The primary function of every human brain, after all, is survival; we are hard-wired for protection. As a result, the brain, having been stuck in a chronic circumstance within which it has been told its well-being is threatened, has—by reflex and with utter immediacy—chosen to Fight-Flee-or Freeze in the face of that danger. Amplifying this process has been the protracted length of the Pandemic; the human brain is a marvelously adaptable and highly efficient machine—meaning that, whenever it is placed in any environment for a lengthy period of time, it will turn on the chemicals it thinks it needs, and decrease production for others deemed as unnecessary. For example, an individual who has been clinically depressed for a lifetime has a brain which, ostensibly, has turned off the production of serotonin and endorphin in an effort to be efficient; given its chronic state of low mood and decreased ambition, the brain has come to believe it does not need these ‘feel good’ chemicals.

In the realm of the pandemic—and particularly during the ‘force-multiplier’ states such as the Critical Periods—the brain will react in a similarly efficient way. Believing it remains under constant attack, the brain has entrenched itself, firmly, in its ‘reaction place’, ready to fight-flight-or freeze. As such, it is, perpetually, also releasing plenty of the stress hormone, cortisol, as fuel.

So what works to help the brain disengage from this process? We surely aren’t able to change the global state of the world; the Pandemic remains, and to date this moment it time remains as a transitory phase.

The following is by no means an exhaustive list of strategies. Rather, it is a primer containing suggestions and supplying biochemical reasons why these strategies work. Hi-jacking, then re-routing a brain that has, for an entire calendar year, believed it is under attack, is not an effortless task. Like any skill, these strategies will require dedication, discipline, and, above all—practice.

That said, here are some tips to get started.

1. Physical Activity
Why? Endorphins released when we engage in physical activity function as both natural pain-killers and mood-elevating agents. Beyond that, physical activity forces the body out of its place of stasis, which has become a complicating and compounding factor within this pandemic. In addition, physical activity is, almost 100% of the time, a benefit to our physical health—the upside of which is obvious; over this protracted time of the Pandemic, there has been a disproportionate fixation on physical well-being.

How? Choose activities wisely; nothing that elevates or reactivates anxiety will in any way be helpful, so it is actually to our benefit to avoid competitive sports right now, and for young people, also any activity that requires them to ‘pick’ teams (hugely anxiety inducing). Instead, gravitate toward individual activities: brisk walking, stretching, weight lifting (where age appropriate), yoga, etc.—and to exacerbate the benefits of these activities, incorporate music that is either calming, or highly upbeat. Why music? Because music resides in the emotional arena of our brains, and as such—like activity—listening to pleasing music activates the release of endorphin, dopamine, and DHEA, our feel-good hormone, which will all then work together to light the brains’ reward pathways, and to elevate one’s sense of well-being.

2. Creativity
Why? When we create anything—art, a journal entry, a tricky succession of chords on the guitar—the release of those same feel-good chemicals referenced above (dopamine, endorphin, et al) flood the system, elevating mood, creating a sense of well-being, even acting as natural pain killers. In addition, engaging in any creative endeavor is a mindfulness activity, which keeps our brains wholly in the moment, unable to ruminate on the past or worry/obsess over the future.

How? Creativity is by no means limited to the artistic. Need a shelf of books or resources rearranged? Re-figuring them is a creative activity. Got over a hundred pictures you’ve snapped on your iPhone? Curating albums to organize them is a form of creativity which will light the reward pathway up as readily as the watercolor artist or poet’s pathway is engaged by their activities. In other words, any endeavor that ends in something that pleases your eye and offers a sense of accomplishment is a creative activity that has activated the chemistry we want flowing in the body.

3. Curate and /or Limit Content
Why? Anyone who has taken Traumatic Events Systems with Kevin has heard him say “Denial gets a bad rap”, and it is true; there is much merit to the old cliché ‘out of sight, out of mind’, and it is this: if we continue to expose, then re-expose, ourselves to traumatic stimuli, then how can we expect our brain to ever exit the reflex to ‘Fight-Flight-or Freeze’? Remember, when the brain is faced with any cue that feels threatening, it will not wait for logic to make a discernment. The reflex to fight-flight-freeze occurs quicker than your heart can beat. As such, exposure and re-exposure to traumatic stimuli keeps the brain in a perpetual state of reactivity and elevated cortisol—and you will not be able to reason your way out of it, no matter how hard you try. And it is difficult, if not impossible, to ‘model calm’ when you are, in fact, anything but. So…

How? Be ruthless in not only in limiting your exposure to traumatic stimuli, but also in defining what has become traumatic stimuli for you. Check your own baseline behavior! For example—does seeing the face of your State or Province’s Chief Medical Officer evoke an immediate, churlish reaction within you? Does hearing the term ‘social distancing’ on the radio make you sad or angry? These are not childish reactions, they are emotional anchors your brain has formed which have married the term /face / content to the perceived need to react.

Yet here’s the rub: we all, as human beings, have a tendency to want to know the gory details. It’s why we all gawk out the window at the car accident even though we know what we see there may be wholly upsetting. The challenge then, in caring for ourselves right now, is not to gawk. And it will be difficult. We have formed, over this long year, something of an addiction to seeing the daily case numbers, the responses, the memes, etc.

But the brain needs a break from the unceasing hits of cortisol, and as such it is our duty to care for ourselves by limiting, or even eliminating exposure to whatever our brain has encoded as traumatic stimuli. This also may include people. Never have we experienced a more broadly encompassing polarizing event than this pandemic has become, and we know, from VTRA, that polarization is a fast-track to dehumanization. As such, many of us have had exchanges between friends, co-workers, and even family members that have devolved into combative, anxiety-inducing, even threatening experiences.

So, am I suggesting your Facebook feed become nothing but cat pictures and cheesecake recipes?

And, that said…

4. Humor
Why? Like creativity and physical activity, laughter releases endorphins into the system, and while the data are clear that this is merely a short-term solution, it is nevertheless a viable solution—and what’s more, every time endorphins are released, the brain is reminded that endorphins are necessary, and as such it re-builds its muscle memory to release them. In addition, studies reflect that pain tolerance increases when we are laughing—and emotional pain, to the brain, is no different than physical pain. And has this Pandemic been emotionally painful? Yes, unquestionably. How? Humor is as individual and unique as a fingerprint. Find what’s funny. Engage. Also consider the cathartic benefits of movies and literature. These genres allow us to experience and process emotions at a distance—via a character—and as such can make a positive impact with how we interpret and move through emotions.

5. Conversation & Dialogue
Why? Because just as we have never seen a more polarizing event, nor have we ever experienced one that’s left so many feeling both literally—and figuratively—alone. And while we are indeed hard-wired for protection, we only thrive with connection.

How? For leaders reading this (leaders of organizations, classrooms, or even if you are the leader in your family), designate safe spaces and/or safe times within which people can talk and feel heard, respected, and validated regardless of thoughts, opinions, or stances. By-pass the content, and go directly to the feeling; saying “It is scary, isn’t it?” neither agrees nor disagrees with what is being said, and instead acknowledges the emotions that are crouching within the content. “I’m discombobulated too” is also not agreeance with content, but is an honest validation that, we are, in fact, ‘all in this together’.

Bonnie Randall, Consultant and National Trainer, NACTATR

Conclusion
One of the greatest barriers to successful self-care is leaving our most important relationships systems unattended to. The above recommendations will have limited value if at the core of our functioning one or more relationships need repair or reengagement. If there is a “meaningful conversation” you know needs to occur with your partner, child, parent, friend, colleague or other, make it happen! The additional emotional energy it will take when most are already tired will be a moment in time only. By having that conversation, you will infuse yourself with emotional energy when you make a successful reconnection. Then all of the above strategies will be exponentially more powerful in bringing back some peace, harmony and hope, even in the midst of a pandemic.

Bless Your Hearts!
Sincerely,
J. Kevin Cameron, Executive Director, NACTATR