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Pre-Traumatic Stress

Ep #313: Pre-Traumatic Stress

I’ve been hearing from lots of frontline healthcare workers and from my coaches who are coaching these heroes about what they’re feeling right now. There’s a lot of fear, worry, and anticipation.

The anticipation of pain, suffering, and stress is also known as pre-traumatic stress and it’s a very real thing healthcare workers are experiencing right now.

It’s important to remember that you have a choice when it comes to trauma. You can resist and avoid it, feeling afraid every day that it might come. Or, you can acknowledge it, feel your feelings, and separate your anxious thoughts from the facts.

Today, I’m talking all about pre-traumatic stress in hopes that our healthcare heroes can find resilience and strength in spite of their fears. I’m talking about balancing your thoughts, finding peace in your anxiety, and giving you a practical way to calm your brain.

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What You will discover

  • How the anticipation of stress (pre-traumatic stress) only leads to more stress.
  • How to come to terms with your anxiety and feel your feelings.
  • Why, good or bad, we never know what’s going to come next.
  • How you can protect yourself without worrying or being anxious.
  • That your brain has the power to freak out, but it can also calm itself down.

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Get the Full Episode Transcript:

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Episode Transcript:

You are listening to The Life Coach School Podcast with Brooke Castillo, episode number 313.

Welcome to The Life Coach School Podcast, where it’s all about real clients, real problems and real coaching. And now your host, Master Coach Instructor, Brooke Castillo.

Well hello, my friends. Today, I want to talk about a concept that was brought to my attention by many of the healthcare workers that we have in our community. We have a lot of nurses and doctors and people on the frontlines right now in our community. And they’re telling me what’s going on and telling me what they’re struggling with and how they’re coping with it.

And I feel really strongly about utilizing what they’re learning and what they’re talking about and offering it to you and to any other, maybe, healthcare worker that you know of that isn’t in our community yet that we can help in every way we can.

So, let me tell you what the original post was, from Olivia. She said, “Brooke, I was just talking to a nurse about coaching and she was talking about what it’s like in the hospital; the panic before the storm. And she referred to it as pre-traumatic stress. I thought it would be a great topic for the podcast.”

I since learned that there was an article written by a doctor on this concept, pre-traumatic stress. So, I went to do some research on it. As most of you know, I did a podcast on post-traumatic growth; a concept that I had studied, I think it’s been a couple years now.

And that’s had such a helpful impact for so many people that have had trauma, those of us who have had trauma in our lives, that have had a hard time processing it and working through it because we have felt like it’s something that will plague us for the rest of our lives have been really inspired by that concept of post-traumatic growth.

And the concept there is that we are stronger because of the trauma instead of in spite of it. It has been part of our life that was meant to happen. And I’ve recently been, at night, watching, I think it’s on Prime, I just started watching a series, I think it’s called the Rook. And when I say I’ve been watching it, what I really mean is I’ve been falling asleep to it.

But one of the concepts in there is there is – I don’t’ really know what’s going on because I keep falling asleep. But in general – so, if you’re a huge fan of the show, don’t be mad at me if I get this wrong – but there’s people in the show that have superpowers-ish. And one of the people in the show has the power to erase memories.

And it’s really interesting, I was just watching yesterday and there was a woman who her young daughter had been gang raped and she wanted this guy that has the ability to erase memories to come and erase that memory of that experience so she could be happy again. And it had such a profound effect on me seeing that happen.

So, the young daughter was traumatized and depressed and then he erased her memory and she was right back to normal. And I started thinking a lot about that in terms of my life and what trauma means and what all of the negative experiences mean for us in our lives and is the point to have a life without them and to erase them, or if we have the choice, do we use them as part of our life experience?

And the truth is, we do have that choice. We have that choice whether to push it away and ignore it and not process it. and we have the choice to move towards it and utilize it. and in fact, I just bought the book, The Choice, that I’m going to read. I think it would be really helpful for me to read, especially during this time. And it’s a psychiatrist’s experience with the Holocaust and how she made a choice with that experience.

So, I wanted to talk about this idea because I think it’s so fascinating and I think it will be useful for so many of us who are having what we could call pre-traumatic stress. I’ve seen it with so many of my clients. It’s the anticipation of stress. It’s like the fear of the fear, the anticipation of the stress is stress itself. So, I wanted to share some of the replies that many of my coaches and doctors and nurses had made from this original post by Olivia.

Michelle says, “As a nurse, I’d say that’s what I’m dealing with most. Not for myself, but for triaging calls, walk-ins, emails, endless bombardment of pre-traumatic stress from everyone. I am raw from the mental work. I’m happy to be helping, but I’m physically and mentally depleted to the point that I just don’t want to talk anymore, just go home and stare at my floor.”

So, it’s not even, at this point for Michelle, it’s not even the people that are coming in that are sick that are calling her and needing help. It’s the people anticipating that they might get sick. It’s that anticipatory situation that’s causing a lot of stress and a lot of trauma and wearing everybody out.

And so, I had replied, I said, “Oh I love this topic. And I also love the topic that our health workers are motherfucking heroes. What do you all believe is the solution to pre-traumatic stress?” That was the question that I asked to the coaches.

And Stephanie says, “I think the anticipation of what is to come contributes to the pre-traumatic stress, at least for me. The idea of waiting to see if we get sick, waiting to see if we have enough food and supplies, waiting to see what will happen next. And what I have found most helpful in managing my mind and thoughts is finding peace in being with anxiety and the intense vibrations in my body. I’ve also been working on finding thoughts that bring me feelings of peace. I’m taking care of myself and my kids. This is the perfect opportunity for me to learn how to manage my mind. Anxiety is not a problem. My body is amazing and can heal itself. I experienced childbirth twice and I can experience this too. This is how it was always going to happen.”

And then Sarah says, “I think the answers to pre-traumatic stress are feeling your feelings, going to the worst-case scenario and showing your brain that you can handle it. My husband is a doctor and those two skills have helped me so much when my brain freaks out about what might happen.”

And then Kara adds a number three to Sarah’s and says, “Coming back to the present moment and remembering that we never have any idea what is coming next, we just sometimes think we do.”

Another Kara says, “This is a great point and reminds me the exact opposite of anticipation is the best part of a vacation, as was mentioned in the coaching call Friday with the woman who had to cancel her 40th vacation to Thailand. So, on the opposite side of that, all the anticipation of what’s to come in terms of how this will affect society is magnifying the anxiety. We get to dread it for longer as it plays out versus looking forward to it.”

So, I think this is really interesting. I have talked a lot about how sometimes anticipating a vacation, anticipating Christmas, the day before Christmas is actually better than Christmas. And sometimes, I think our anticipation and our fear of what to come is actually worse than when it’s here, when the actual circumstance is here and alive.

My solution to this is a little bit different to what I normally recommend and I think it’s because of the way the circumstance is so collective. And the way that I’m recommending that we deal with this is a little bit different. So, here are my thoughts on this.

This idea of stress ahead of time, the way that it was defined was intrusive involuntary images of possible future events. So, I think it’s important for many of us who are trained in the model and for many of us who are coaches, I think the word involuntary images, involuntary thoughts is really important for us.

The brain is looking to be startled to it can protect us. So, it will be looking for thoughts that freak us out. And by understanding that those are involuntary, we can stop trying to control them and beating ourselves up for having them. That’s first and foremost.

The absence of control is something that we’re all experiencing acutely right now. And the truth is, we have very little control always, but we don’t think about it because our braid doesn’t like to think about that. And it’s almost like we’re being forced to consider that.

So, we are using our imagination right now to fear the future. It’s a misuse of the imagination because people think and we think worry is necessary and worrying ahead of time is preventative. And one of the things I’ve been really trying to convey is that we can be protective and responsible and educated and careful without worrying.

The worry part is not necessary to be preventative and to protect ourselves and listen to the guidelines and follow them. But we don’t have to be afraid in order to do that. And I think some people think, “Well I’m not going to take protective measures because I’m not worried about this.”

You don’t have to be worried about it to be smart about it. And I think that’s an important distinction. And I’ve talked a lot already on the podcast about how important it is for us to be collaborative with each other instead of blaming and criticizing and finger-pointing to everyone. That is not going to help in this situation. We need to be inclusive and we need to try to understand where people are coming from when they aren’t taking the action that we think they should be taking.

I think one of the main thoughts that I’m seeing the most with people experiencing this pre-traumatic stress is, “I won’t be able to handle it,” or, “We won’t be able to handle it.” That is a thought that because there’s so much evidence coming from other countries that are ahead of us on this curve about what’s going on in the hospitals and what’s going on with the doctors and all of the things that are happening is we jump to the conclusion that we won’t be able to handle it.

And I think that’s very normal to be having a thought like that. And I think the imagination going there and panicking is actually very normal, especially those of you who are doctors and nurses who are going to be helping and healing people that are in the hospital with this virus and the likelihood that you will be exposed to it and get it because you’re in the hospital and because of how contagious it is and the circumstances that are going on in this hospital.

So, I think thinking about that and allowing yourself to feel and experience that is very healthy actually. I do not think we should be brushing that aside or pretending that’s not a possibility, anything like that. And so, sometimes in my coaching, I don’t think it’s useful to entertain thoughts like that. But in this situation, I actually do think it is.

I think it’s important to allow the imagination to go there, understand it’s the imagination, but still allow yourself to go there. My recommendation is that you also utilize the imagination for the alternative.

The truth is, we don’t know what’s going to happen in the future. We don’t know. It’s completely uncertain. And when we think that we know, when we’re like, “Look what happened in Italy, look what happened in China, I know this is going to happen to me and I know I’m not going to be able to handle it,” you’re not right about that.

You have no idea yet. So yes, go there in your mind. Allow yourself to have that worst-case scenario. Allow yourself to look at the evidence and be afraid. But I also am recommending that you then offer your brain the alternative in equal time amount.

So, if you spend 20 minutes anticipating the worst-case scenario, give yourself 20 minutes to imagine the best-case scenario. Go to the future and imagine that you could handle it and that you did handle it and that you’re strong enough to handle it and that you wanted to go to work and do what you did because you did.

And I think understanding what a badass you are, being on the frontline of this, helping people heal in equal amount to being afraid and worn out and exhausted will give you that balance that you need. It’s very easy at a time like this to drop into despair, and we need to drop into despair.

We need to drop into anxiety. We need to drop into fear. We need to do that. But we don’t need to stay there the whole time. We want to give equal airtime to other possibilities and other imaginations that are possible.

Some helpful questions that I think will help lead you to some more positive thoughts on the other half of this airtime we’re giving to our imagination is what can I do? How can I do and be my best right now? How can I feel what I’m feeling without shutting down? How can I allow it?

Some of the thoughts that I’ve been working with, with some of my physician clients and nurses that are right up front in this is offering a thought that includes both emotions. So, instead of just saying, “I’m afraid.” We’re adding onto it.

So, “I am afraid and resilient. I am worried and capable. I am exhausted and skilled. I am freaked out and contributing.” By putting them both in one thought, it balances it a little bit. Now, I want to be careful here to make sure I tell you, if you’re a coach and you’re coaching someone in the health industry that is needing help, or even if you are coaching yourself on this, you want to make sure that the thoughts you create are true to you.

And what you will find is there is equal truth in terror and in joy. It’s equally true that this is awful and terrible and scary and that you are strong and resilient and capable. And so, find the words that have the most truth for you. You cannot pretend your way to peace. It will not work. You have to find a grain of what is true.

And so, for many of the doctors that I was talking to, they know that they’re skilled. That is not in question. And they know that they’re resilient. I mean, just getting through to become a doctor, you have to be resilient. So they know that those two things are true.

So, when they can add those to their feelings of terror and fear, these people that I’ve been coaching have been feeling a sense of balance there and not just the sheer terror. It helps them. They know that they’re scared, but they also know that they’re skilled and capable and have the ability to help. And that feels more powerful.

So, my suggestion to you is to just recognize that the mind can’t help it. it needs to go to that worst-case scenario because for some reason it feels necessary in order to protect you. So, allow it to go there. Don’t fight it because that will wear you out.

The future can only hurt you in your mind the way that you think about it. and what I want to say – and I know this sounds kind of counterintuitive – is let it hurt you a little bit. Let yourself go there. You can handle the hurt and the stress ahead of time. Allow that. But also allow the possibility of goodness and healing and resilience and health and capacity and the human spirit to overcome. Allow stories of that as well.

So, here’s my advice. Sit down and write down all your scary thoughts; all of them. And separate it out from the facts so you really notice that your thoughts are what is creating how you’re feeling, and that’s okay.

And then find thoughts that are equally true on the other side, that create a different sense of feeling, that create feelings of strength and capability and contribution and resilience. And play with those throughout your day. Shift back and forth to, “We’re all going to die,” to, “Some of us are going to live,” to, “I might die,” to, “I might live,” to, “I might get sick,” to, “I might not get sick,” to, “My children might get sick,” to, “They may not get sick.”

Just play with both sides of it and allow what it feels to feel both ways. And make sure those thoughts feel true to you. Do not lie to yourself. Do not deny yourself. But also open to it and allow both sides of it.

I really do think that the power of the human imagination can traumatize us, but it can also heal us. So, how we may be feeling stress ahead of time and freaking ourselves out and freezing ourselves and immobilizing ourselves ahead of time. I think we could also use that same power, that same extraordinary power of our imagination to feel peace and relief and capability and strength ahead of time.

Take the time to pay attention to your mind. It is the most powerful thing you have control over right now. And by being able to do this work and use your mind in the best way possible in a situation like this, you will be able to take that into your life after this is over, during this whole time and after this is over to understand yourself as a human, to understand your brain more and to understand how to get through the hardest of hardest times.

This is an opportunity for us if we see it that way. This is a curriculum for us, if we see it that way. I don’t see another alternative. And that might be important for you to explore, is like, we’re in it. This is what it is right now, so what can I do to be who I want to be right now and also acknowledge that I’m human and scared and my brain is doing lots of crazy things to freak me out, but it also has the power to calm me down.

Alright, my friends. Have a beautiful week and I’ll talk to you next week. Take care.

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