Sunday, November 29, 2020

America was a traumatized nation even before Covid. We need to start healing.

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Hippocrates first identified medical “crises” as times in the evolution of an illness when the symptoms of chronic dysfunction and disorder reach an inflammatory crescendo.

He observed that these crises could be extinguished by death or fester as chronic illness — but, if a physician understood the nature of the crisis and addressed its causes, and if its sufferers were both physically and psychologically supported, they could often transform the grave threat into what he called a “healing crisis.” He described a healing crisis as a cleansing, detoxifying process that gives birth to a new, more integrated and stable state of physical and emotional health and wellbeing.

This latter crisis successfully resolves when physician and sufferer stop trying to subdue its symptoms but instead regard them both as arrows pointing backward, toward the causes of distress, and forward, toward the means to resolve it.

America, too, has long been suffering from chronic dysfunction and disorder, and 2020 has seen our problems as a nation reach an inflammatory crescendo. We need to transform this into our own healing crisis — and there are some hopeful signs that this may be happening.

Our challenge as a society now is to sustain and embrace the changes the healing crisis is bringing to America.

The Covid-19 pandemic — with its invisible and unpredictable course, its forced isolation and rampant unemployment — created a global, national and personal crisis which few alive have ever seen. Like the crises Hippocrates observed, this one has brought unaddressed disorders and vulnerabilities to the surface, in our body politic, as well as in our individual bodies and in our elected leader. As it has unfolded, it has exposed our greatest inequities and vulnerabilities: Black, brown and Indigenous people who are more likely to have been weakened by poverty and discrimination, chronic illness, poor nutrition and inadequate medical care, have been dying at twice the rate of whites; and 80 percent of all Covid-19 fatalities are among older people.

None of us, however, is exempt from the virus’s devastation or the fear it brings. Physicians like me are observing that previously controlled chronic conditions like hypertension, type II diabetes, arthritis and migraines are flaring. Psychological and behavioral vulnerabilities, probed by pandemic fear and uncertainty, are surfacing: a study just published in JAMA Open Network revealed a “threefold” increase in depressive symptoms; the Disaster Distress Hotline of the US Government’s Substance Abuse and Mental Health Services Administration reports a 900 percent increase in calls to its suicide hotline; child abuse is increasing; drug overdose deaths are up by 42 percent.

George Floyd’s murder in May put the depth and lethality of American inequity in bold relief and fueled the crisis even as it gave a long-traumatized Black population and its allies a renewed sense of purpose. President Trump’s continuous attempts to downplay both the severity of the pandemic and American systemic racism fed its flames.

Those who have faithfully taken their cues from the President are also manifesting symptoms of the national emotional crisis. Their furious armed mobilization against basic public health measures and the threat of inter-city invaders, the homegrown terrorist plot to kidnap Michigan’s governor and threats to “Stop the Steal” all resemble what Hippocrates called “aggravations.”

And now, as winter approaches, the crisis continues to broaden and intensify.

Pandemic-induced isolation has exacerbated emotional distress and physical illness, but also made many of us more grateful for the human connections we do have.

Over the last 30 years, my Center for Mind-Body Medicine colleagues and I have had the opportunity to help other populations to move through and beyond the trauma that has devastated them — after wars in the Balkans and the Middle East, opioid epidemics and school shootings in the U.S., and hurricanes and earthquakes that have killed thousands and shattered the lives of millions in America and the Caribbean.

Young people in Gaza who’d lost family members in wars between Hamas and Israel and aspired only to revenge and martyrdom have used our program of self-care and group support to discover unimagined resilience and transform despair into generous, compassionate hope. An eight-year-old boy who wanted only to wear the suicide bomber’s belt came to imagine himself as “the driver for the first president of Palestine”; a broken-hearted nine-year-old girl who wanted only to be buried with her father, two uncles and an aunt who were killed by Israeli bombs now aspires to be a doctor, tending to the war-hurt hearts of Gazans.

Here in the U.S., resident-Elect Biden has turned his own traumatic losses into a commitment to compassionate care that can nourish our national healing.

And we Americans have been readying ourselves for the healing and transformation for which we hope. Millions more of us are now embracing meditative practices that offer an antidote to chronic distress and confusion, as well as pandemic-induced anxiety, agitation and sleeplessness — practices promote “compassion” and “loving kindness,” as well as long term physical and psychological health. Many Americans, including those who do not formally meditate, report being more “aware” or “mindful”; they are bringing a new perspective on and greater appreciation for what is truly important to them.

Pandemic-induced isolation has exacerbated emotional distress and physical illness, but also made many of us more grateful for the human connections we do have. FaceTime calls, Zoom get-togethers, and online classes have increased exponentially. Though overwhelmed by non-stop childcare, parents I know are discovering new ways of playing and learning with their children. The masks we wear to safeguard others as well as protect ourselves are visible and palpable reminders that all of us are connected to and dependent on one another.

Routine activities — preparing and eating meals, re-organizing closets, nurturing plants, walking by trees — feel newly satisfying; absent luxuries no longer seem essential; and threats to the social fabric, the political order, and the environment are coming into sharper focus. Many white Americans, hunkered down in pandemic induced isolation, have become sensitized to the vulnerability and pain of others less privileged. Large numbers, recognizing the festering wounds of genocide and racism, have committed themselves to draining the infection.

Our challenge as a society now is to sustain and embrace the changes the healing crisis is bringing to America. We must cultivate the meditative mind which quiets anxiety and agitation, promotes reflection over reaction and values understanding more than argument. We have to engage ever-more appreciatively and kindly with the people in our lives. We need to look more closely and critically at the illusions of safety and superiority which have blinded us to our vulnerability and condemned us to self-limiting self-protection. We have to deepen our understanding that we are all connected to and responsible for one another and the natural world which sustains us, and to commit ourselves to faithfully fulfilling that responsibility.

James S. Gordon

James S. Gordon, a psychiatrist, is the author of “The Transformation: Discovering Wholeness and Healing After Trauma,” a comprehensive step by step guide to trauma-healing, and the founder and executive director of The Center for Mind-Body Medicine. A Georgetown Medical School clinical professor, he chaired the White House Commission on Complementary and Alternative Medicine Policy under Presidents Clinton and G.W. Bush.

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