I received a call from Eric in mid-April asking for counselling, at the height of COVID-19 in London, and Eric had just escaped covid-19.
To my shame, when I got a call from Eric, my curiosity overshadowed any sympathy or concern for him— and I didn't like this reaction. Fortunately, when I saw his thin cheeks and heard him talk about the five days he had experienced putting on the ventilator, the gasp in his voice made my therapist self back on the line.
Eric's face was magnified much by the screen, and I could see his blurry brown eyes, pale oval face, his round-rimmed glasses and gray beard that gave him an academic touch, which was very appropriate for Eric, a retired anthropology professor from Hackney, seventy-two years old, married, and both children of adulthood. Eric spoke slowly and stopped several times to catch his breath, but he told his story roughly.
He woke up one morning feeling physically tired and became more and more unwell in the days that followed, his speech became a little deranged, and his wife Paulina began to worry more and more, but Eric was still unable to face his physical condition, insisting that "others will get sick, and I will not be the monopoly of a coward." But in the days that followed, his body began to tremble, his body temperature hovered between too high and too low, and his legs were cold, and his eyes began to glow, but because he did not cough, Eric was convinced that he was not suffering from COVID-19. When his body temperature climbed to 41 degrees Celsius, his daughter called an ambulance for him despite not staying with him, and six minutes later, the ambulance arrived.
Eric remembers being put in a wheelchair and remembering "being strapped to an oxygen machine and injecting antibiotics." In the process of speaking, Eric suddenly lowered his head, and his mind seemed to enter a dead end where he could not continue to travel. I let the silence continue between us.
"I'm not alone with myself when I entered the hospital, I've been changed."
My instinctive reaction will lead me to follow Eric's statement and ask the obvious question: How did you change? But from his slow, breathless words I could sense that there were a lot of black holes in his mind, and I didn't want to make him feel more depressed. So, in order for him to understand that it was normal to have such a strange feeling, I replied in a relaxed tone: "Of course, you must have changed, you were in a coma for many days, you had a terrible mechanical tube in your throat to help you breathe, you lived in a roaring and hot intensive care unit, and the people around you were wrapped in a protective suit like a space suit, how could you not change?" ”
He lifted the corner of his mouth and smiled and nodded. As our conversation continued, his spirits slightly better, and he said, "If you want to devise a system to intimidate an elderly person like me, insert a tube into him and keep anyone he knows, loves around him..." At this point, his body began to shake, as if the memory of his body was flashing before his eyes, and his voice lowered: "The most terrible thing is that when they intubated me, I felt as if I was drowning... I thought I was going to die. ”
Subconsciously, I put my hand on my own throat and felt the preciousness of being able to swallow freely, and the experience he recounted made people feel really afraid. After talking about his experience, he still exuded natural optimism: "When I was able to breathe on my own, I cried, I can't remember the last time I cried, my life was changed, but also saved, I want to continue along this road." 」 ”
Based on this sentence, I ask Eric: Does he hope that our work will help him cope with the trauma of this disease, and also help him understand how the disease will change the course of his life? He nodded. He was a little tired, the day's consultation was over, and we said we'd like to continue in the next few weeks.
Eric said: "I feel weak... My memories, my legs and feet, my whole body felt no longer strong. I can walk, but I still need to use a walking frame, and I still have nightmares at night. I want to go back to my old self... Just five weeks ago, I was healthy. ”
Eric described to me how hungry he used to love walking, and he took long hikes on holidays, walking frequently every week. As he described how strong he once was, I could hear the pride in his words. Before his illness, he was a dynamic seventy-two-year-old with a wide range of interests, especially helping young people; he volunteered to work for the Prince's Fund, tutoring many teenagers every week. But now, his body and mind are experiencing the after-effects of a deep trauma and need positive rehabilitation to help him heal.
Earlier, in a conversation with a counselor, I tended to emphasize some of the actual habits and behaviors in life that are beneficial to physical and psychological recovery, and after the chaos, it may help to make life look like it is back in order by establishing the structure of life.
I asked Eric if he had developed his own routine after he came home from the hospital, and Eric told me that his general daily routine was to do some leg rehab exercises before breakfast, write a few emails in the morning, Prepare lunch for him, and then he would take a long nap in the afternoon. "I feel like an old-fashioned man, and I remember watching my father snore in front of the TV with disdain, completely ignoring what was going on on on the TV, and we agreed to watch the football game together. And now, I'm just like him. ”
What we need to do is change his depressed mental state by strengthening the rhythms of daily life.
I naturally showed a guiding posture, which made it easier for him to accept my opinion, and we discussed together what he liked to do. He agreed to incorporate three new habits in his daily life: going outdoors for at least thirty minutes a morning, taking a nap, watching his favorite paintings to enliven his mind, then sketching, doodling, or simply applying color on paper, so that self-expression would have the effect of self-expression, and finally, I taught him a "safe zone" meditation exercise, recalling a place where he could feel calm when he had been alone as an adult.
I told him to close his eyes, breathe, and feel the images he could see, the sounds he could hear, the smells he could smell. I then taught him to cross his arms across his chest, each hand on one shoulder, and as he exhaled and exhaled, slowly tapping his shoulder for at least five minutes. This pose, called a butterfly hug, is a way of communicating between the left and right brains through dual attentional stimuli, which reduces stress levels and soothes the body. He can do this at the end of a day to transition himself to a night state.
I heard that his wife, Paulina, was eager to help him with his recovery, but she was in a high state of anxiety, and it was often more than worth the loss to help her, but it caused a lot of trouble. As he talked about Paulina, he paused several times to inhale, as if Paulina's anxiety, as well as his own, were falling into his heart.
I realized that if one of my partners is sick, the healthy one will feel deeply uneasy about the other person's pain while trying to support the partner. I can imagine Paulina still feeling the fear that Eric might have died, and at the same time, taking care of Eric, the once stronger party, could also frustrate her, hinder her sympathy, and make the relationship unbalanced.
However, it is too early to discuss with Eric the impact of the illness on their relationship, we need to stabilize Eric first, and for future reference, I said to Eric, "Your illness may also shake your relationship with Paulina on many levels, and when you are better, we will need to look at this problem." Eric's answer confirmed my suspicions: "The people closest to me now feel the farthest away from me... I felt a chill of loneliness in my body. ”
The loneliness Eric felt was twofold. His communication with his two daughters, Lucy and Catherine, can only be limited to online, but what he longs for most is to be able to hug them and feel the love and warmth they pass on. As he imagined the day the isolation was lifted, all he could have then, I saw wetness in his eyes. But Eric's loneliness also stemmed in large part from the trauma left by illness in his body, in depths where language could not reach, and he frequently recalled his ordeal in the intensive care unit.
I wanted to use eye movement desensitization reprocessing therapy to repair his abnormally stored memories and adapt to these memories in the present moment. This method may be mechanical, but it is an extremely simple and effective means of reconnecting the content of induced memories with parts of the brain that heal and dissolve such memories through two-way stimulation and eye movements.
I explained the method to Eric and came with text messages and links to the website. After experiencing the trauma of severe COVID-19 and follow-up treatment, it is important for him to be able to understand what we are doing, not something that is being imposed on him, but something we are doing together. At the same time, I also needed to perform a series of tests to make sure that he was psychologically stable enough to withstand the feelings that were brought back by the recalled memories.
The results of my evaluation taught me that Eric was very tough by nature, and that there were no extreme twists and turns in his life as a child, which was the factor that most easily made the treatment process difficult. His parents fell in love, albeit perhaps in an old-school way; he had quite a few friends; he was able to read well the emotional messages conveyed by his body and to realize that he could actively use many methods to achieve peace. Our ability to connect easily also reflects his fundamental trust in himself and the world. At the time, I didn't know how our treatment would go, but I believed he would end up with a good outcome and wouldn't need treatment for long.
Eric's four eye movement desensitization reprocessing treatments focused on his memories and the images that would be triggered with them, a treatment designed to release stress from his body. These are images of a tube inserted in his throat, a snake in his hallucinations, a giant python, and a terrorist with a strange yellow and red face; the moment when he has difficulty breathing, when he struggles to breathe, when he feels like he is about to die and is unsure whether to continue struggling, and the moment when the patient dies beside him.
Each session is different, but one thing runs through it: every time I stimulate him, his strong negative emotions invade his body with these pictures, feelings, and thoughts. For several moments, I was worried that the intense emotion that Eric had evoked as he recalled the image of the python would crush him, and it would look as if a tornado was whizzing out of his body. But he was not crushed.
In the course of each stimulus, I would give him the reassurance of "Well done... Very good..." and by making eye contact to get that information visually, there were a few times when I had to get him to open his eyes and look at me. At the end of each series of stimuli, I would ask him, "What have you noticed now?" "Then the treatment continues. Then what he calls "a strange gust of wind" will come as his brain gradually calms down, his perception will become more positive, and the traumatic memory will appear "more distant." For example, he remembers that during a sedative injection before the endotracheal intubation, his nurse Rachel would hold his hand, look at him kindly behind the mask, and tell him, 'You'll be fine, start counting...".
This memory of a simple expression of humanity brought him to tears of gratitude. Connections between the left and right brains are established. At the end of each part of the treatment, Eric is exhausted but at the same time very happy, because he feels that the trauma is leaving his body.
I know this process sounds strange and like a charade, but the effectiveness of eye movement desensitization reprocessing therapy has been recognised by the Uk's National Institute of Hygiene and Wellness and the World Health Organization, and has been supported by many evidence-based papers. And my experience as a doctor has taught me that this approach does have strange and inexplicable effects that can make a very significant difference. And mastering the methods that can truly heal my patients' suffering is also extremely exciting.
Outside of our treatment, Eric's physical strength is gradually increasing thanks to his naturally strong physique, and his doctors have shown that his own physical foundation is a very important factor in rehabilitation. He no longer uses walking aids and has gained weight. He walked for an hour every morning and his mind became clearer. Now, we need to combine his sick experience with his future life and, more importantly, shift our attention to his relationship with Paulina.
Through Eric, I learned how terrified his wife was about his illness.
Paulina soothes her anxiety by staying busy, running around, looking for something to do. At the same time, she often violated the hospital's visitation policy, always bringing her food and care to her family or friends at the hospital. So when she couldn't accompany Eric and was left alone at home, alone, alone, when text messages from friends and family asking for information flooded her like a flood, and the apocalyptic scenes were in her mind, it could really drive her crazy.
In order to be able to say a few words to the nurse or doctor on the phone, Paulina endured the pain of endless waiting on the phone, sometimes she could get a conversation and get all the information about Eric's situation at the time, and sometimes she could only hear a few words "no change". Luckily, a few days after Eric was admitted to the intensive care unit, Paulina met Rachel via video (the same person eric remembers rachel holding his hand), and when Rachel was on duty, she became the lifeline that stabilized Paulina. She not only conveyed information to Paulina, but also chatted and laughed with her. Knowing that someone she trusted and loved was watching over her husband made Paulina feel a little calmer.
After Eric returns to the regular COVID-19 ward, Paulina calls every day, and the brief content of the calls surprises Eric. Although he admits that "home has never been so good", unlike the tearful reunions he expected, mutual comfort, hugs from Paulina and loving words, he was greeted by only an anxious wife with his lips closed, who tried to meet his care needs during the first week of his home, when he was still weak. As Eric spoke, I could observe that he was very hurt and extremely confused by his wife's reaction. Especially when he was touched by people's well-meaning text messages, greeting cards and flowers, he said, "I didn't know there were so many people who liked me and they all seemed happier than my wife was that I was alive." ”
I smiled at him, let him know I understood how he felt, and said that perhaps Paulina's need to close herself was just a testament to the depth of her feelings for him, a depth that was directly proportional to her fear of his possible death, a fear she didn't know how to bear. I continued, and I thought she might be angry with him too. Of course, she didn't do it consciously, because it was not "allowed" to be angry with a sick person, but in fact she may feel that she has been abandoned by him, and perhaps, part of her is thinking angrily: "I don't accept, I don't want a sick husband, I want my husband who has been healthy for the past forty years, not this husband who has scared me." ”
After all my rhetoric, I was smug about my subtle observations, and then finally turned all my attention to Eric, who looked a little confused. Frowning and shaking his head, he repeated to me "Angry at me because I'm sick?" I softened my tone and admitted to him that it did seem neither reasonable nor fair. We finished the session, and when Eric pressed Zoom's exit button even more sadly than before the consultation, I felt a surge of guilt welling up in my heart.
For the next week, I'd rather hear Eric and Paulina arguing, than yelling at each other, yelling, venting, and then they feel better and get back together. But the client didn't come to satisfy the stories we made up, and in Eric's specific case, he didn't meet my expectations for a clean solution. In fact, they had a very torturous week, and they continued to misunderstand each other, cycle back and forth, then for days refusing to talk to each other, and then they would return to the practical but lack of intimate communication of "handing over the butter." Of course, being in isolation and lacking friends to help them change their moods will not help them reconcile. Their daughters, Catherine and Lucy, also struggle to help out, as they both need to release their concerns about Eric's health from their parents.
But they brought in the goods they bought and the meals they had prepared, and they did help on a realistic level. Eric repeatedly talks about how much they don't support him, and how tired he is of their unfair reactions. There's no doubt that this response is unfair, but at the same time, I admit in my heart that people can't put logic into the emotional system. They are all shaken in their own way by Eric's illness, which deprives and exhausts their ability to take care of each other after the crisis is over.
Through the feedback from my mentor, I realized that we had a clear goal in both the rehabilitation and eye movement desensitization reprocessing procedures we had, and eric was regrouped. My mentor generously didn't repeat to me the fact that I was a counselor, and I told people that we had to mourn our former selves, to mourn the loss of life, and to tell people that it would take time, longer than we were willing to give, to emotionally catch up with the events of our lives. However, I'm not living up to what I'm advocating, or, in a less harsh way of saying it, that I'm not paying attention to time after completing my eye movement desensitization reprocessing treatment, after the trauma has been released from Eric's body— Eric needs time and space to mourn and adapt to this new, once near-dead self.
What Eric needs is to face his own complex feelings in the moment. I repeated this message to him and asked him if he knew what was going on inside him. "I feel sad... Sad for once my own naivety, now I know that I too may die, and I will eventually die. I couldn't put that thought out of my mind anymore. With these words, tears quietly wet Eric's face, and I felt as if there was a lump in my throat. I gave him space and it was reasonable to give him feedback on his grief.
It is also helpful to look at his story from an anthropological perspective and to interpret his family's reactions from a cultural, behavioural, and social perspective. This realization excites him and helps him absorb the story as part of himself. He realized that he could read the story whenever he wanted, but the story was no longer in front of his brain, occupying all his emotional space.
And as he had more emotional strength, his relationship with Paulina also got better, he wrote a letter to Paulina, and throughout their marriage he had been writing to Paulina, and he was able to express his feelings in writing better than verbal language. He told her how much he loved her and admitted that his illness must have been very difficult for her. He began to make small gestures of love for her after his retirement, such as bringing a cup of tea to her bed every morning. As time passed, she felt safe with him again.
That meant she had enough trust in him to express her sadness to him and a multitude of mixed negative feelings that had allowed her to isolate herself completely. The rhythm of their once-lives is back, they enjoy the sun together, they enjoy meeting their children and friends in the park. I know our joint work is nearing completion. It was a frightening experience, but it wouldn't leave him with lasting trauma.
This article is excerpted from