Since mid-March, most of the world has been coping with unprecedented events that have left us grieving over a multitude of losses generated by Covid-19. We have been living for many months now with a perpetual fear of falling ill, and even now, this stress is compounded by uncertainty about the course this virus will take. Many of us have, indeed, been very sick, and unfortunately, we can barely process the loss of people who have died from this little-understood, ravaging disease.
At a minimum, our lives have been turned upside down. We need to exercise great flexibility and creativity to support the business of everyday life, as well as the serenity, meaning and spirituality of Shabbat and holidays. As I write these lines, work and school are conducted remotely from home, with parents juggling resources, time and space to ensure that adults and children alike can fulfill their responsibilities. Shuls were closed just when we most needed spiritual, communal and social support. We were forced to recalibrate and figure out ways to connect socially while sheltered in place. These changes have taken their toll on all of us as we ride the waves of gratitude for each healthy day along with the disbelief that it is not yet over.
How do individuals move from despair to optimism? What accounts for the differences in the time it takes for different individuals to do so?
Yet, as we have seen in the aftermath of plagues and traumas of the past, we survive. We don’t simply survive, but thrive, building meaningful relationships, close families, strong communities and successful work lives, once the traumatic events pass.
How is resilience possible? What factors contribute to a greater likelihood for resilience following trauma? How do individuals move from despair to optimism? What accounts for the differences in the time it takes for different individuals to do so? How do we understand the qualitative differences in the way resilience takes hold among survivors of trauma? Most importantly, what can we learn from those who have demonstrated resilience that can help others rebuild their shattered lives?
I will attempt to answer these questions through examining a fictional case of a patient in my psychotherapy practice.
Carol came to therapy in February with symptoms of anxiety. She had suffered from anxiety on and off over the years, yet at the time we met, it was at a very high level and interfering with her daily functioning. In many ways, Carol enjoyed a good life with regard to family and work. Although news of the spread of the deadly coronavirus was just beginning to surface, Carol insisted she was not fearful of it having any impact on her or those closest to her.
Listening to Carol’s family history, I learned that both of her parents were Holocaust survivors. Her mother, Edna, the oldest of eight children, was the sole survivor of her family. Liberated from a concentration camp at the end of the war, she spent time in a DP camp, where she met her future husband, Maurice Cohen. Though broken physically and emotionally, Edna and Maurice married, with a desire to begin their lives anew. Soon Carol was born and the family immigrated to the United States shortly after. The family grew with the birth of two additional children, and the Cohens opened a dry goods business on the Lower East Side which enabled them to purchase a home in one of the outer boroughs. On holidays and celebrations of life-cycle events, their home became the center for large gatherings of other survivors and their children, who became family for one another in their reconstructed lives.
While Carol’s parents achieved the hallmarks of a successful all-American family, they suffered from nightmares, mistrust of most “outsiders” and the belief that the disappearance of their good life was inevitable. Carol sensed that they felt guilty over the pleasure they experienced from the success they had achieved. There was a clear disconnect between the external evidence of a secure life for them in a new land, and the internal experience of their being haunted by the feeling that this life was only temporary.
Growing up in a home with happiness only thinly veiling detachment and sadness, Carol and her siblings were keenly aware of this disparity in their parents’ lives and the price that their parents’ traumas exacted from them every day. Carol had learned years ago that her lifelong struggle with anxiety was, indeed, tied to her parents’ traumas. This phenomenon has been named “trans-generational trauma” and has been studied by many psychologists. Many children and grandchildren of Holocaust survivors who exhibit symptoms of anxiety, depression and obsessive-compulsive disorder have been helped by tracing the connection to their parents’ and grandparents’ traumas. Their symptoms are believed to be, at least in part, the result of problematic attachment to their caregivers, who themselves struggled with internal disorganization and incomplete or unresolved grief and mourning.1
This is what we call resilience: the process of adapting well in the face of adversity or trauma.
Despite acknowledging the pathology that continues to impact subsequent generations of trauma survivors,2 we must also recognize and learn from the strengths and accomplishments of those who we might have expected would remain deficient in their relationships and productivity.3 For despite the anxiety, depression and other symptoms, survivors and their progeny have repeatedly demonstrated that they can build impressive lives, drawing on strengths that coexist with their pain, and even flourish in optimal environments.
This is what we call resilience: the process of adapting well in the face of adversity or trauma. Current post-traumatic emotional growth is possible even while fighting the ever-present demons of the past. Psychotherapy as an instrument of growth can significantly help mitigate the cycle of emotional self-destruction and offer tools to enhance inner strengths while quieting negative voices within. Telling one’s story to a psychotherapist diminishes the grip of the trauma. It is the experience of telling the story of one’s trauma that provides a clearer awareness of one’s feelings, which are often repressed in the service of moving on. It is not until one can “mentalize,” that is, conceptualize, the experience that a person truly mourns the losses involved in the trauma.4 The therapist is able to tolerate the painful details and respond in an empathic way to the speaker so that the process will be effective. This therapeutic sharing can lead to resilience and minimize the negative impact of unresolved grief and mourning.
Furthermore, every person carries a narrative that is the unique story of his or her life, with particular influences and life experiences prior to the trauma. Trauma victims who had loving families and comfortable, stable lives through their early years may be equipped to survive the trauma with a more stable inner life. The duration of the trauma, as well as its quality and intensity, will further dictate the extent and likelihood of the resulting pathology, resilience and growth.
It is also clear that the emotional and behavioral reactions of those who are around the trauma victim during and after the trauma will influence the degree of his or her resilience. If the traumatized individual has his feelings validated while also being assured that one day this event will pass, the chance of emerging with a modicum of optimism and strength is higher than if he faced negativity and fear on a constant basis.
Carol was an infant during the postwar years and did not benefit from calm, confident parenting, as both of her parents were barely past their traumatic experiences. Yet, because of the auxiliary parenting experiences of her close-knit community, Carol did benefit from a lot of attention, love and encouragement from other adults. She was also raised and educated in a traditional home and school, where prayer and the presence of God were constant values. Therapy helped Carol manage her troubling fears and find other ways to continue to rally her inner strength and grow.
Despite all the losses that we have been experiencing during this pandemic, it is clear that it is very far from the traumas of the Holocaust. Nevertheless, from the dynamics of this fictional case, we can learn about basic principles of resilience following trauma that can be helpful to us in our situation as well.
As I write this in June, the pandemic is not yet over. We can expect that months of radical change, accompanied by major fears of health threats and financial loss, will require all of us to continue to rally our strengths in order to survive and thrive. We must draw on our self-awareness and self-care in order to become secure and healthy once again. But we cannot do it alone. We need connection to others: to God (spirituality), to family and friends, and to our communities. Healing is promoted with the help of a psychotherapist or other professionals who have experience with trauma. We will benefit from mutual support, connection and care, as we heal from the trauma of Covid-19, one of our generation’s most challenging experiences.
1. Peter Fonagy, Affect Regulation, Mentalization, and the Development of the Self (New York, 2002).
2. Selma Fraiberg et al., “Ghosts in the Nursery,” Journal of the American Academy of Child and Adolescent Psychiatry 14:3 (1975): 387-421.
3. Alicia F. Lieberman et al., “Angels in the Nursery: The Intergenerational Transmission of Benevolent Parental Influences,” Infant Mental Health Journal 26:6 (2005): 504-520.
4. Richard Mollica, Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World (Nashville, 2009).
Ways to Help Others Become More Resilient:
1. Listen to others and validate their fears, frustrations and corona fatigue.
2. Assure them that this is going to end while acknowledging that we have all been dealing with multitudes of losses and disappointments for months now.
3. Inquire which activities bring them comfort and encourage them to pursue them. Suggest some of the things you have explored.
4. Remind them of their inner strengths that have helped them deal with adversity in the past. Help them remember the people and messages from those who gave them strength in the past as well as from those who continue to give them courage currently.
5. Suggest professionals who can support them during these complicated and disorienting times.
6. Stay positive!
Ways to Become More Resilient:
1. Eat and sleep well and exercise regularly.
2. Express gratitude for all the good things in your life.
3. Reach out to others (via FaceTime and Zoom, or face to face as restrictions lift) for support and companionship.
4. Draw on the internalized voices and messages of people you have learned from regarding dealing with adversity and developing resilience.
5. Avoid negativity and pursue positivity.
6. Limit your exposure to news media that focuses on conflict and uncertainty.
7. Pursue your comforts: read, listen to music, meditate, write or journal.
8. Be creative: paint, garden, complete a puzzle, cook, bake, learn a new language, or take up a new hobby.
9. Study: There is a plethora of online learning opportunities. Pick any topic!
10. Plan an activity or trip for when the world opens up again. Meanwhile, take a virtual tour of a museum or follow a guide in a foreign country.
11. Speak with a psychotherapist to help you regulate your fears and anxieties in order to achieve the goals outlined above.
Shana Yocheved Schacter, RCSW, is a psychotherapist in private practice in New York City and Teaneck, New Jersey.