For most patients, the COVID-19 crisis has created a “new normal.” They may be stuck at home, unable to work, or feeling isolated from dear friends and family.
This all can leave people feeling helpless.
So what can we do to help patients regain a sense of agency during the pandemic? Bessel van der Kolk, MD has several ideas.
Take a moment now to hear them in the video below.
Just one note before you watch: there’s a section that Bessel specifically asked us to leave in, even though we’d normally remove it. However, this time he wanted you to be able to hear it for yourself.
According to Bessel, there are insights we can draw from trauma therapy that could help patients when they’re feeling helpless or reeling from the unpredictability of life during a pandemic.
Now think of the patients you’ll be seeing this week. Is there a strategy from the video that one of them might find particularly helpful?
We understand that not everyone will agree with Bessel’s politics, and we appreciate that we have a community of practitioners from both sides of the aisle. But for the comments we’d like to focus on what we all have in common: our work with patients.
Please let us know a strategy that one of your patients may find helpful in the comments below.
I have so much respect for Dr. Van der Kolk, and I appreciate the note regarding his politics. I just would like to add that while everyone is entitled to his or her own political views, I was disheartened to hear the addition of them because the mere discussion of politics can be anxiety provoking. Adding the element of anxiety seems incongruent to Dr. Van der Kolk’s life work. I will continue to follow and learn from him, as I believe he is the foremost leader on trauma. However, I hope that we can set politics aside and help people where they are at, rather than placing personal opinions on those we seek to help. Therapists are not called to give advice, or interject agenda. Therapists help people find answers for themselves that fit with their personal belief system, in an effort to feel whole, or find congruence.
Viktor Frankl would agree that we can only control our response in situations riddled with problems. I have offered the suggestion of structured routines to parents who have been overwhelmed by having their children back home. I have suggested they have a block of time set aside for learning for their children. At least four hours. Thank you for making me feel I am on the right track. Dr. Cora Butler-Jones
The moment you believe that our work is apolitical is the moment you stop advocating for our clients! I despair at the privilege that some have where some cannot see the political context of our lived everyday – thank you for saying just want a lot of us are thinking!
We are all experiencing a multidimensional treat – the virus, the economy, the social, the institutional and the political – there is no moral weight added to statements like this, nor the comment Bessel made. Just the universal truth of Covid-19, a truth that is creating the deep seeded unpredictability that sits at the heart of all of our trauma responses.
Once again, Bessel has the authoritative voice that we all need right now. Practical supports and a validation of what just is. No big words, nothing to magical thinking away problems, no sugar coating and nothing that asks an individual to rewrite their whole world when the world around them makes no sense.
What is it that they say – the more people focus upon the bit that confronts their own world the better your world for the world!
Great video and insight about predictability. And YES, we have a political virus too!!
Thank you for providing a grounded response in this difficult time. This was helpful for me as a psychologist … confirming I am on the right track, guiding clients to have as much structure/routine/predictability in their day as possible.
Thank you again ….. from Lockdown in New Zealand 🙂
Parallels with when dealing with loss and grief, structure, agency, trust of self, tether to practical matters can be very empowering, yes move body to anchor self, Xcellant!
Very practical feasible explanations and not hard to digest. Love the part about the crazy man at the head of the political virus – that made me laugh which I really needed – all excellent advice, add some music music is vital in getting through trauma!
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Absolutely great, thank you so much Ruth and Bessel, so clear and so down to earth. Am very happy to have been able to listen to this.
Absolutely wonderful. Great ideas! Glad you kept it in. It is important, many people experience what he is talking about in regards to the president.
Thank you for leaving his comments in – this is a powerful and important message. It is validating to hear it said out loud by someone so well respected.
The lack of crucial medical equipment and other forms of medical preparedness is the result of the president’s severe pathology. It greatly contributes to the sense of uncertainty and fear. His emotional instability, rage, and attacks result in people feeling fearful.
Clinicians can contribute to this pandemic by offering clarity and facts. Correctly interpreting what underlies this crisis. A source that people can trust because it is reality-based. I am so proud that Bessel had the courage to speak out and hope that others in our profession will do the same.
Thank you for leaving it in. He’s right on. I’m making a vido of a free shamanic meditation which I’d like to share with everyone…
Practical and helpful tips about reclaiming agency, and good insight into the helplessness many are experiencing in this present moment, including the part about not being able to trust the authority figure of our “crazy” president. It’s extremely relevant to the anxiety many of us are feeling at the moment .
Thank you so much for this-for leaving the section in that otherwise might have been edited out. This video was for us all and so needed.
Very insightful! Thank you!Blessings!?
Dr. Bessel van der Kolk seems to be expressing the paradoxical essence of the Serenity Prayer: by accepting the unacceptable, we can change the unchangeable. Acceptance changes the only thing that really matters…how it affects us. Thank God for faith (ha!)…it actually works.
Now, about that “crazy” President…politics, religion, spirituality, psychology…it’s all the same thing, it all amounts to your belief system. We’re all professionals here. Would you prefer Narcissistic Personality Disorder? Psychopathy? Dementia?
Nah, Bessel nailed it.
I really appreciate what you’ve said. I have felt a new understanding of life itself is brewing. Thank you
Bessel,
Thank you for this. I know it is aimed at what we do as practitioners, but it was helpful to me personally today. My mother has had a stroke and I have been unable to visit her, even at the handoff to rehab, because of the pandemic. I’m feeling the unpredictability of the situation, and my own inability to do a lot to help. What you said has been the most practical help out of everything I’ve heard since the outbreak.
Hi. Just to say I am so sorry that this situation is going on for you. I hope she recovers quickly. Sharon, LCSW-R
We need Leaders such as therapist and doctors to help actually calm people who are already in fear, angry, anxious and suicidal during this pandemic by providing tools and tips, not personal political opinions which provoke and offend readers. Whether one likes or dislikes a particular party/person this is not the venue of which to spout off.
I liked the positive approach. It is strength based insofar as it focuses on what we can do This attitude is an important antidote 2 feeling helpless or depressed. I am telling CT’s 2 remember that we hav a good governor. I live in Calif. I believe the same about other governors. If CT’s express rage n frustration at the current president I remind them 2 take action re: existing organizations who resist the current president. I emphasize the word “current” 2 draw attn to the fact that no president can b in office more than 2 terms. I would add that the parallel process is tiring. It makes it harder 2 so tx
Thank you so much for including the section where he talks about the madness of our collective “parent.” Nothing contributes more to our traumatic sense of helplessness in the face of this pandemic.
Simple good common sense and achievable in little steps.
Well I find it interesting that “ structure “ now is the new crutch for us to lean on . For a long time we called it distractive busyness so we don’t need to observe that which we don’t like . It’s all rooted in control neediness. Faith is better antidote. Faith in the goodness of humanity . Faith in our institutions. Faith in our ability to persevere. This time now of collective vulnerability gives us a chance to make a choice . Choose faith in yourself and your innate ability to be calm and resilient.
As for political trauma , well in a democracy how much control do you expect when the majority rules , and you don’t like the rules of the majority? Plus you vote only once every four years so how much input do you really have in the political system . Thinking otherwise will just give you neurosis.
Unfortunately, majority does not rule, the electoral college does. Millions more of us voted for Hillary than the president, but our votes were invalidated by this outdated system. I appreciated Bessel’s views. What is making me anxious is the lack of consistency of how states needs are being responded to, with governors that flatter the president getting more help and supplies than those who don’t. Thank goodness my (CA) governor is working hard to shelter the homeless and providing consistent caring leadership. I believe the instability at the top does affect clients.
I found this video very helpful. I am about to write a message to each of my clients who I ordinarily see regularly on standing days/times. Now that we have moved to Face Time/Skype/Zoom I want to say something encouraging to them. I would like them to keep their standing days and times on these new platforms, as well. What Bessel suggests is just what I need to share. Regain a sense of agency through having control of your day. Make yourself the one who determines what is going to happen each day at particular times. Including movement and incorporating having agency over the body is a great point, as well. And yes, as we are not only living with an unpredictable virus, our geopolitics do not give us much comfort or predictability which exacerbates the situation. I’m grateful you chose to include that point. Thank you.
As always, solid life affirming advice from Bessel van der Volk!
Have structure in your life, be in touch with your body be in touch with friends and recognise that we are in a time of trauma!
…Rena del pieve gobbi
Yes!
While I agree with Dr. van der Kolk’s political focus (right on!) we must focus on our patients, many of whom are front line providers themselves. “The Body Keeps the Score,” changed my life and explained my life; I can’t thank the good doctor enough for his tenacious research, pulling together threads of my childhood at age 7 when I suffered a massive infection in my left hip, requiring me to spend my very 1st “summer vacation” hospitalized and terrified; finally a surgical consult required opening my hip through my left buttock, leaving a ten inch “crescent moon” scar, after removing 2 cups of pus (yeah I know it’s gross), and then IV infusions of fluids through my hip to a drainage bag.
Helpful advice. I’m glad you didn’t cut it.
This was very practical, doable and makes total sense! I feel more in control already. Thanks for leaving “it” in…its a part of our trauma environment.
Excellent advice and so spot-on about not having a “parent” we can trust, a parent who is stable and predictable!
This is why I am so glad that I am a resident of NY State and have Governor Cuomo as my leader. He is sane, intelligent, proactive, consistent and loving! His daily updates help ground me.
Agree, we do need a leader who is responsive to America, to all the pain and anguish we have been exposed to before this virus made the situation even more worrisome. Fear did not just start with this virus for many of us and needs to be part of our awareness. Thanks for the work we have been lucky enough to receive in the past six plus years that NICABM has provided for our universal professional growth on trauma. You have provided a respectful ground for stability in a chaotic world. Thanks, Bessel. All therapists need to be authentic when it is necessary, well placed and provides a platform for reality and awareness.
I cannot emphasize STRUCTURE enough, and the need to make as much as life as PREDICTABLE as possible!
Thank-you for that confirmation Dr. van der Kolk.
LaDema Cummings, Mental Health NP, Indiana USA
I like what Dr. van der Kolk has to say about the need for structure.
I would, however, qualify it by saying that while one should make a schedule, one doesn’t have to follow it obsessively. To follow any or all of it can be an option but not necessarily a “personal requirement.”
Dear Dr. van der Kolk:
Thank you for your clear and precise offerings regarding dealing with the current need for isolation, etc. I will definitely follow your advice. Even though I may have stored this information away somewhere in my psyche, it was your words that woke me up. Presidential remarks: I’m definitely with you! As a Dharma teacher and retired Nurse Practitioner
I offer Deep Bows,
Renee Potik
Dear Dr. van der Kolk:
Thank you for your clear and precise offerings regarding dealing with the current need for isolation, etc. I will definitely follow your advice. Even though I may have stored this information away somewhere in my psyche, it was your words that woke me up. Presidential remarks: I’m definitely with you!
Deep bows,
Renee Potik
Covid-19 has given us a huge reminder of who we have control over–that humbling life long lesson. Thank you for the video, excellent tips and reminders for working with our clients.
And while, we might like to separate politics out of life, it is impossible. I support leaving his comments in and applaud your decision to do so.
This video is one of the most organizing, transparent and supportive I’ve seen about our situation from a therapeutic perspective. I deeply appreciate the section you left in. For me, it allowed an experience of a white-European-male-educated person witnessing and articulating elements in our world right now that are deeply harmful for me, which is a very rare thing in my life. It then combines that healing experience with gently firm but supportive suggestions for this situation regarding nutrition and movement that weren’t for me about male-gaze or results, but about kind self respect and self support and agency, embodies empowerment, which is also healing. Thank you all. ??
As a person who has experienced extreme childhood trauma, I thank you for being real, genuine, direct, compassionate and transparent. Thank you for reminding us of the absolute necessity of commitment ourselves and to life by committing to a positive and nurturing schedule. Just like in sailing , or anatomy the boat goes where you are looking and the body follows the head. I personally know that positive structure helps keep my mind in calmer waters and my body is grateful. I stared a gratitude journal at night where I write down for just 10 min something special and wonderful about life that this isolation made possible for me to experience without denying the challenges. There can be both together and it helps me to sleep better at night. Best Wishes t All.
Thank you very much Dr. Van der Kolk for sharing this ideas with us.
I really liked how you addressed the importance of structure and the examples you gave. Practical ideas such as cooking, Yoga and exercise are simple and easy to follow, and I am sure they can help a lot. And I would also like to share how singing can also be very useful during times of distress. I feel a lot better if I sing when I am very worried or anxious.
So helpful like so much of what I appreciate is coming from nicabm. Thank you.
Thank you. Concise brilliant advice.
This was validating for me; thank you. I have been doing almost exactly this with several of my clients, having them write down their structure for the day, and going over it with them. Another thing that I tell them is to start the day getting ready, almost as if they were going somewhere. Take a shower and get dressed into something comfortable but presentable. It’s very easy to sit around in the same sleepwear day after day. Getting ready for the day also works for me.
Thank you for this information it is very helpful.
I appreciate the efforts that are being made to keep this information fresh and remind us all of the basic practicality. I find the reinforcement of these concepts as helpful as I continue to provide support to my clients, friends family and especially to keep myself grounded. Thank you.
i agree, bessel,
all things need structure. in zen there is no vessel without the space within and no space within without the vessals, surround.
the sea has the shore, the sky the horizon, the night, the day.
life is bounded by death. it is important that we accept and depend on the boundaries. the limits of time and space, to be safe. they provide predictability, safety, trust. trust leaves hope.
hope allows agency. agency-action, action-life.
david pezenik, lcsw, private practice, n.y. onsite councelor google n.y., special advisor to crate mind.
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I like the way you present your support of structure and the need for boundaries/parameters-which ultimately, guides us, keeps us safe and creates a feeling of security ….very well stated.
5 stars – high five!
Thank you! Some of us have less control over our schedules (i’m running after my son who has ADHD & ASD) but for those who do these are great suggestions! Yes, and we def. have 2 viruses!
I appreciate that you offered Bessel’s thoughts just as he said them. I appreciate his goodhearted and well informed truth-telling, and found those qualities central to the point he is making. Thanks for having the integrity to post this brief video as is.
If you agree with Bessel’s opinion, then of course you see it as “good-hearted” and well informed truth telling, and “found those qualities central to his point.”
Please people, as therapists and coaches, don’t we “preach” empathy, seeking not to give others the benefit of the doubt, not seeing people as all good and all bad and especially in a crisis. Not all people see and hear things the same way.
I respect Bessel for his expertise in trauma, but that doesn’t mean he has objectivity in the realm of politics and politicians.
Agreed. We do not need any more divisiveness in this country. Our political climate is filled with hate on both sides. We do not need to encourage that divide with our clients or each other. I work hard to calm people down in this arena, showing no bias or favoritism. Everything else I can use and appreciate it being said.
Agree. Honesty has been in short supply in widely dispersed political proclamations from Washington DC. We all pay for this, if we pay taxes. In the context of the current crises, it seems gracious and warranted to accept a personal opinion in a professional communication from someone who has so exceptionally contributed to the knowledge base and training of mental health professionals.
I feel both tolerance and respect for the informed opinions expressed here.
Good wishes forward.
Thank you,
Elizabeth Bryant, Ph.D.
He needed to mention the political reality, whether you like the current president or not. It’s a part of our trauma experience. Thank you, Bessel.
The politics reality involves people in both parties at the top!
Thank you for your directness and honesty about what we are dealing with – corinavirus and politics!
Bessel,
Thank you very much for this very helpful presentation. As a therapist and a wellness practitioner, I especially appreciate your astute conceptualization of the impact of trauma and the focus on our personal agency to establish structure. Therefore, it validates and reinforces my ability as a therapist to empower my clients (and myself) during this “pre-trauma” state.
Diane Kern, Ph.D., Therapist, District of Columbia