Lifelines: How COVID-19 Creates 'Pre-Traumatic Conditions' in the Brain

May 4, 2020

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Parts of New Hampshire’s economy are starting to open up, but a stay-at-home order remains in effect. We’re still crowded into houses with restless kids, still out of work, and still missing a lot of the things we used to do. 

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Dr. Bessel Van Der Kolk is a Boston-based psychiatrist, trauma researcher, and author of the best-selling book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. He says the isolation of staying at home can create what he calls a “pre-traumatic condition.”

NHPR’s Peter Biello spoke with Dr. Van Der Kolk about how trauma affects the brain and body as a part of NHPR’s new series Lifelines: Addressing Trauma in the time of COVID-19.

I'd love to talk to you about the science of trauma and how coronavirus is affecting trauma survivors, if at all. But I wanted to start with the basics about how trauma does affect the brain. So can you explain that? How trauma in general affects the brain?

Brain function is changed by trauma. So if people have an overwhelming experience where they feel there's nothing they can do and they are overwhelmed by it, certain parts of the brain go offline, primarily the frontal lobe, and you automatically activate your fight, flight, or your freeze responses.

So trauma tends to knock the brain offline, the frontal lobe...

Many structures, many brain functions get affected. One of them being the ability to plan, to project into the future, to have a sense of perspective of this is then but tomorrow will be a different day... As the brain loses its higher cortical functions, which are the mature functions of the brain that allow adults to basically be adults, so people become very primitive and get into a state of terror, of fear, or shut down. 

Terror, fear, or shut down. And how does that manifest in the body? You've done a lot of study on that.

The body collapses, you're unable to take action, or you start automatically going to fight-flight. So you start running or hitting or stuff that is sort of wired. So we have these very primitive legacies of our mammalian ancestors, that if we are scared, we start running as fast as we can and we start fighting as fast as we can.

I'd like to ask you about how the coronavirus pandemic may be related to trauma. The pandemic's been difficult for everyone, but those who've experienced trauma in their lives may find it particularly difficult. Can you explain how the stress of coronavirus is different from what you understand as trauma?

I call the coronavirus a pre-traumatic condition. So the stage is set for people to really be very vulnerable to trauma. It in of itself is, for most people, not a trauma, but there's two conditions. One is you're immobilized, so you cannot move around. And immobilization is one of the core preconditions for getting traumatized. And the other one is that you don't know what is going to happen. So you cannot say tomorrow will be a different day or the day after. And so when the world's unpredictable and you cannot move, then the vulnerability to become traumatized is very great. So if you have a pre-existing post-traumatic condition, the chances that you will fly off the handle, that you'll lose your temper, that you’ll beat up on people, or that you will lie curled in front of your TV, or that you will get into alcohol or drugs to calm your system down is very great.

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Under normal circumstances, you have advocated for things like yoga or group activities that may include singing as a way to connect the body to the brain and to assist in healing, or at least unblock the brains of the brain can heal itself.

Actually, a lot of people are doing online yoga, and online music activities right now, actually. We all saw the images of Italians singing to each other and even in my rather uptight neighborhood in Boston, people also are singing to each other in the evening. So the can exchange them, people move together. That gives you the sense of rhythm together. We're basically a rhythmical, tribal people who like to move with other people. For example, I told a friend yesterday, boy I really miss walking through the West Village. It's noisy. I don't know anybody. But you sort of move together as a clump of people and it gives you a sense I'm a member of humanity. Singing together gives you a great feeling of collectivity. Sitting in the yoga class with other people also gives you a sense of attunement with humanity, which is very central to our well-being, actually. And so I think a lot of people are doing that, at least in the world that I live in, everybody I talk to is doing stuff like that.