Bob Schwartz

Mental-health professionals say that no single event since the second world war has left so many people in so many places traumatised at once.
The Economist, August 29th, 2020 (The common tragedy: Worldwide covid-19 is causing a new form of collective trauma)

That one sentence from the current issue of The Economist stunned me. I reread it several times. It is not surprising, given first-hand experience or second-hand reports. That doesn’t make it any less startling.

Just as the diminishing or outright dismissal of the pandemic continues to be dangerous and deadly, so will any similar delusion, as a second “invisible enemy” is following in the steps of the virus.

More from The Economist:

For some, the second half of 2020 will bring much-needed relief. For the time being the number of new recorded global infections has plateaued. In many countries it has dropped dramatically. Yet for those places hit hardest, a full recovery will depend on more than getting the virus under control. In a world paralysed by death, survivors are everywhere: icu patients who faced the horror of covid-19 first-hand, doctors and nurses who cared for them, relatives forced to mourn over WhatsApp and Zoom, families who lost their livelihoods. Mental-health professionals say that no single event since the second world war has left so many people in so many places traumatised at once. How people fare in the months and years ahead will depend partly on how their countries—and, more importantly, their communities—respond….

There were no large-scale psychological studies during the first or the second world wars, though the Holocaust would become the event most deeply associated with mass death and grief. Researchers in the early 2000s found roughly half of Holocaust survivors were still suffering from ptsd. Many had other disorders such as schizophrenia. Even among non-Jewish Europeans who were children during the war, 10-40% still had ptsd symptoms. In communities of survivors, research has shown that “inherited trauma” can be passed to subsequent generations, by growing up flooded with their parents’ memories, and possibly, through genes.

The suffering caused by covid-19 falls far short of the horrors of the Holocaust. Still, Krzysztof Kaniasty, a psychologist and disaster expert, points out that the pandemic presents nearly all the risk factors for ptsd. It has caused sudden death, life-changing events, large-scale social ruptures and chronic stressors like uncertainty and the added hassles of daily life.

The luckiest will suffer mildly from one or two of these effects. Yet more than at any other point in recent history, millions of people have been slammed by all of them….

There is a danger that political divisions, social distancing and economic woes will over time lead to a loss of togetherness in the same way that displacement after the Buffalo Creek flood gave “a degree of permanence to what might otherwise have been a transitional state of shock”, in the words of Mr Erikson. Communities cannot grieve together because the disaster is ongoing and the threat has yet to disappear, says Judith Lewis Herman, a psychiatry professor at Harvard Medical School. She describes three stages of healing: re-establishing safety, remembrance and mourning, and reconnecting with others. Social distancing complicates all of them.

And so like the pandemic itself, the psychological fallout will require assessment and adaptation. Many doctors are still focused on saving lives, but governments and mental-health professionals should start thinking about “psycho-social” interventions.