Transcription:
Tools to Help You Cope With the Trauma of COVID-19

Bill Klaproth (Host):  Are you having trouble sleeping? Do you find yourself overreacting to things that have never bothered you before? Is it difficult to focus on your tasks? These may be symptoms of trauma associated with the COVID-19 impact on your routine. Dr. Katy Maher, Clinical Psychologist in VCU Health’s Level I Trauma Center is here to help us identify symptoms you may be experiencing during the COVID-19 crisis that are similar to the trauma patients she treats. Additionally, she will share some coping strategies you can use today.

This is Healthy with VCU Health. I’m Bill Klaproth. Dr. Maher, thank you for your time. First off, can you tell us about your role in VCU Health’s Trauma Center?

Katy Maher, PhD, LPC (Guest):  Well I like to describe it as if your loved one had a serious physical trauma like a motor vehicle collision, they will likely be admitted to VCU’s level I Trauma Center. So, there’s a huge team of staff that just surgeons and nurses that work on the physical healing and I think of myself as the doctor that works on emotional responses. And we know after a trauma, that traumatic injury is consistently linked with emotional distress. So, I was hired as a clinical health psychologist to identify and treat trauma patients post injury.

So, my biggest role, is I actually work inpatient seeing individuals during hospitalization. I also have a small outpatient clinic and I supervise a bunch of trainees who also work within our trauma center with our patients.

Host:  I think the mental impact of a traumatic situation, like the car accident you were talking about often gets overlooked. We pay attention to the physical impact as we should, but that mental component is very important as well. So, how do you work with trauma surgeons and nurses and how are the patients screened?

Dr. Maher:  In 2014, the American College of Surgeons actually recommended that trauma centers screen all patients for PTSD and depression. They had found about a quarter of patients who were admitted had high rates of PTSD and depression during admission. So, at VCU, the trauma center decided not only do they just need that screening, but they need mental health staff that will provide treatment for these patients. So, I’m embedded right into the trauma center. I go to the medical rounds and I also get consults. So anybody that is in the hospital that needs mental health support, I’m available to see them.

Host:  So, in what ways then are people responding to COVID-19 similarly to your patient’s response to their traumatic event?

Dr. Maher:  Well if you think of a patient going through a physical trauma, they’re challenged with this very sudden and difficult path that’s really unexpected. Which isn’t so different from what we’re experiencing right now with COVID. So, there’s a variety of responses to a traumatic event that you may not even identify as a trauma response. So, for example, having difficulty sleeping, lack of energy, or even anger.

Host:  All right so you said difficulty sleeping, lack of energy are some of the symptoms anger. Do you think people recognize these symptoms especially if they haven’t experienced them in this way before?

Dr. Maher:  Well I think with trauma patients one of the first things I do is talk to them about what symptoms are common after a traumatic event. I think while some people just want to immediately make somebody feel better or avoid discussing the hard stuff, I find actually educating people on common symptoms can help normalize a lot of the distress. And while the situation isn’t normal, or okay, we know that our difficult emotions are normal and it can be really helpful just to talk to other people and realize okay, I’m not the only one that is feeling this way right now.

Host:  Right, we’re all kind of feeling this stress and anxiety around COVID-19. So, how do you suggest people then cope with these symptoms?

Dr. Maher:  Well I think that the biggest thing is that normalization of realizing I’m not alone. But I also know that there’s a lot of tools that are helpful to kind of challenge us around this. So, one of the things that I do with my patients is to actually look at the evidence. Almost like you were a judge in court making a decision. So, in my therapy sessions, we’ll actually pull out a physical tool called a thought record where we will look at some of the negative or anxious thoughts and then the evidence for or against those thoughts.

So, I’ll give you an example. Let’s say my thought is I’m going to die of COVID-19 if I go to the grocery store. Well that’s pretty anxiety provoking, right, it can cause me to feel really bad or I may even avoid going to pick up groceries. So, if I do this kind of mental thought record, after examining the evidence and thoughts, I may have a little bit more of a balanced thought such as I can’t be 100% sure what’s going to happen but if I’m being as safe as I can for my family, that’s all I have control over right now. So, this can feel a little less scary and base your thoughts more rationally around it than out of fear.

Host:  Controlling your thoughts sometimes is easier said than done. We all know how hard it can be. Do you have any strategies or tips on how we can control our thoughts better?

Dr. Maher:  Yeah, I think one of the things that is really obvious but that I do a lot is just to focus on the things that I can control right now. So, unfortunately, I don’t have control when or if COVID is going to go away. But I do have control over my behavior. So, wearing a mask, not touching my face, minimizing interactions with others; those kinds of things I can do. But where the problem may lie is if I get into more of like a survival mode kind of thinking and I start doing things that are unhealthful. For example, I had a patient that was spending three to four hours a day washing their groceries or cleaning their bathroom which wasn’t necessarily making them safer. It was actually giving them a lot of anxiety.

Host:  And then because we will get through this eventually, is there a way to use the temporary nature of this to our advantage?

Dr. Maher:  Definitely. I think while in the midst of a traumatic experience, it kind of feels like things are going to be this way forever. They are never going to get better. Which is typically not true. My favorite inspiration for this is Viktor Frankl and if you aren’t familiar with him, he was a psychiatrist who was in a Nazi concentration camp and there’s this story in his book and I tell this a lot of my trauma patients because I love it so much. But one day he was so weak in the concentration camp that he literally fell down. So, in that moment, he said he could have easily made the choice to give up but instead he visualized sitting in a room full of his peers telling the story of how he stood up when he wanted to give up. And he literally told this story to a big group of his peers once he was out of the camp. So, this is something that I’ve done quite a bit in the past several months kind of visualizing a time in the future where I am in traffic, driving to work, maybe stopping at Starbucks on the way to get my favorite drink and then going into the hospital to meet my team without masks or being afraid to infect my patients.

Host:  So visualize what your life is going to be like when we finally get through this. That is a great tactic and then we’ve often heard that you can help yourself when you help others. Is there a coping strategy from helping others that can help us alleviate the fear and anxiety that we feel?

Dr. Maher:  Definitely. I think personally, my anxiety tends to make me think a little bit more about myself and initially when all of the COVID stuff came up, my thoughts were a little bit more about self-preservation which is pretty normal as well as just kind of feeling helpless. So, one thing I did is I actually volunteered to help do some of the counseling of employees that were impacted by COVID via our employee assistance program. And this immediately made some of these helpless things feel a lot more meaningful. Now I know everyone can’t do that, but this could look different. It can be anything from reaching out to a friend who is having a hard day, bringing food to a neighbor or even just being there emotionally for your family.

Host:  Such a great point. And then what about resources available to us. We have all this technology at our fingertips. Is there a way to use that to our advantage?

Dr. Maher:  Yeah, I mean you’ve probably seen all over the news there’s more discussion of coping strategies than ever. If we imagine stress as a wave, I kind of think of COVID as like a giant tsunami. So, if you kind of visualize yourself as kind of riding that tsunami right now, we’re the surfers on a board. Now what we’d like to do is either just kind of jump off which we’d be sucked in by the wave or try to make the wave go away. Which neither of those are possible right now. So, I think of our job is just to stay on the board until we can rid this out to the shore. So, I kind of think of coping tools as not what makes the wave go away but the things that you keep on the board until the wave is past. So, coping strategies can be a really great way to help ride this out. My favorite app right now is called COVID Coach. That just came out by the VA. It has a number of coping tools on it such as meditation and relaxation. But if you go into the app store and type in relaxation or meditation there’s tons of apps out there. Or you can even go on YouTube and find similar exercises for free.

Host:  Ride that wave. That’s what we’re all going to have to do. Dr. Maher, thank you so much for your time. This has really been informative. Thanks again.

Dr. Maher:  Thank you.

Host:  That’s Dr. Katy Maher and for more information please visitwww.vcuhealth.org/trauma. And if you found this podcast helpful, please share it on your social channels and explore the full podcast library of www.vcuhealth.org/podcast for more health topics of interest to you. This is Healthy with VCU Health. I’m Bill Klaproth. Thanks for listening.