About 25 years ago, six students celebrating their graduation from London’s Institute of Psychoanalysis were interrupted by news of a ferry sinking off the coast of Belgium in which 193 people died.
The next day, two of those students travelled to Dover to offer support but quickly discovered something more would be required. Their experience led to the establishment of the Unit to Study Trauma and its Aftermath at the Tavistock Clinic, where I worked as an honorary psychotherapist after my own clinical qualification.
The Tavistock has treated trauma patients extensively and published widely on its psychoanalytic approach, grounded in theory written by Sigmund Freud and Melanie Klein.
Central to its work is a belief that trauma is treated through understanding the meaning of the event for that individual. Treatment pays attention to symptoms and diagnoses while considering past experiences and developmental history in such a way that a person can make sense of their own response to trauma.
So, what determines whether someone has experienced trauma?
We hear the word in multiple contexts, and it exists in various forms. It also occurs on micro and macro levels, from victims of robbery to entire populations caught in the crossfire of war. We might imagine faces of trauma patients belonging to veterans, domestic abuse survivors, bombing victims or journalists. But it can happen to anyone.
In general terms, I describe trauma as any event that shatters an individual’s reasonable sense of security after which their view of the world and their way of interacting with it changes.
Psychoanalytically, it can be considered an intrusion that disrupts a person’s way of thinking, feeling or being.
I sometimes offer patients the example of a person regularly commuting on the same bus with the reasonable assumption that it provides safe transport to and from their destination. We can think about what happens if one day a bomb explodes on that bus causing physical damage but also shattering an internal sense of well-being that can transform the passenger from that day onwards. Alongside physical injuries, care is also required for less visible mental health wounds before a trauma survivor takes steps forward in a world that may never feel quite the same as before.
As I write this, I’m aware we are all experiencing the collective intrusion of Covid-19.
The pandemic could be classified as a traumatic experience for some frontline workers, furloughed staff and grieving families but also those less obviously at risk who may not show any signs of how their hearts and minds have changed.
The impact is difficult to know, or comprehend, unless thoughts and feelings can be shared and that poses a challenge when we are separated from each other with social distancing. I’m writing this to encourage everyone to make that extra effort, reaching out to those you previously encountered in a shared space – whether across the desk or dinner table or anywhere else – to ask how they are beyond their day-to-day activity.
Just as it was 25 years ago, there is no immediate or short-term solution but creating a space to connect and converse can be the start of something important for those who need it most.