Body and trauma

Our society has for some time been subject to great changes, which for some can be a source of suffering, even trauma.

What is a trauma? In Psychopathology a trauma corresponds to «the transmission of a psychic shock exerted by an external agent on the psyche, causing temporary or permanent psychopathological disturbances» definition of Crocq 2007.

Such a shock can occur when the person has witnessed or faced death or the threat of death, serious injury or assault, sexual violence or the risk of violence. This event, known as a traumatic event, constitutes a threat to life, physical and/or mental integrity while producing an intense fear, a feeling of powerlessness, horror, shame. But above all it challenges the essential values of existence such as security, respect for life, peace, morality, solidarity, etc.

With all these elements, can we say that the current crisis we are experiencing due to Covid-19 can be a source of trauma?

Numerous studies are conducted on the subject, including by Professor of Psychiatry Alain Brunet and a team of researchers from 7 major international universities. In an attempt to assess the traumatic impact of the crisis, they set up an online questionnaire available to all, focusing on emotions and feelings during confinement and the overall situation. However, as this study was launched in May 2020, the results and conclusions are not yet available.

If for the global situation we do not yet have precise data to define the traumatic impact, it is to be feared according to Chantal Danoun, clinical psychologist for the health network Récup’air, for patients who have been in resuscitation because of the virus. Indeed, in an article by France Assos Santé published in July 2020, she explains that patients coming out of resuscitation or coma following Covid-19 infection have experienced more dramatically their hospitalization due to the rapid worsening of symptoms, lack of support and explanation from the medical profession, loneliness and weakening of the body. According to her, a wave of patients emerging from Covid-19 and developing post-traumatic stress syndrome (PTSD) is to be feared in the fall of 2020 and prevention and management systems have already been put in place.

However, if for Professor Carol North, a psychiatrist in Texas “the conditions are not right to talk about trauma” it would be more accurate to talk about an increase in chronic stress and anxiety states. Dr Noël Pommepuy, a child psychiatrist in Seine-Saint-Denis, agrees with this observation, The development of PTSD has not yet been really observed, however, it notes a generalized state of stress with an increase in acute depressions and delusional flushes in response to confinement. While in caregivers there is more state of burn out, exhaustion and emotional detachment.

Why did you think the Covid-19 crisis could have caused a surge of PTSD patients?

To answer this question it is necessary to return to the evolution of this pathology. Before PTSD sets in, the person facing a potentially traumatic situation goes through an acute phase where stress predominates. Stress, according to Crocq, is an “immediate, biological, physiological and psychological response to alarm, resource mobilization and defence of the individual in the face of aggression or threat.” These are the reactions to this stress, whether they are adapted or not or if the person remains blocked for too long (more than 2 days) in a state of stress that can lead to the development of post-traumatic stress syndrome.

And we’ve seen that if researchers and mental health professionals don’t agree on the onset of PTSD as a result of Covid-19, they still notice that we’re in a period of stress right now with a strong impact on mental health.

But by the way, what is post-traumatic stress disorder?

PTSD is characterized by three predominant symptoms; dissociation (i.e., emotional, sensory and physical anesthesia, such as disconnection from oneself) reviviscences (intrusive memories of the traumatic event) and persistent neurovegetative activation. The latter includes symptoms such as anxiety and/or depressive disorders, sleep and/or eating disorders, hyper-vigilance, etc.

In other words, trauma deeply affects the body and many symptoms in traumatized individuals have a somatic basis.

Is it possible to get out of PTSD?

To go beyond a trauma, it seems important to us to work with and on the body, hence the therapies with a psycho-bodily approach such as the Somatic Experiencing of Peter A.Levine or the sensory-motor psychotherapy of Pat Ogden. These two approaches have in common that they treat sensory-motor reactions (bodily sensations) not assimilated and generated by trauma. The objective, at first, is to distinguish between physical sensations and emotions of traumatic origin. When the person learns to regulate his or her own excitement through treatment at the sensory-levelIt can distinguish more precisely the cognitive and affective reactions which are symptomatic of those which are real difficulties which it will have to elaborate. According to the postulate of these bodily approaches, the integration and the overcoming of trauma passes first and foremost through its calming in the body.

These therapies would therefore be appropriate for people who have been resuscitated or coming out of coma as a result of the virus because what they have experienced has deeply affected their body and their control of themselves. Patients of Chantal Danoun express a total disarray and the impression of having been that a body connected to machines, a body that has become weak and in need of rehabilitation. In addition to possible sequelae, these patients must face a re-appropriation of their own body.

In conclusion, the extent of the mental health impacts of the Covid-19 crisis is still unclear at this time. Research is still in its infancy and the evolution of the traumatic impact and the installation of a chronic anxiety disorder on the population remains to be monitored.

Sources biblio:

  • M1 Psychopathology Course
  • Sensorimotor psychotherapy: a method for treating the traumatic memories of Pat Ogden and Kekumi Minton.
  • Traumatic Dissociation and Personality Disorders: Or How You Become Alien to Yourself from Muriel Salmona
  • Somatic Experiencing: the body remembers everything about Peter A.Levine

Web sources: