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The current Covid-19 pandemic demands that we urgently revisit the relevance of the term “wounded healer”. We need to take seriously risks and dangers faced by first-line responders within and beyond the health service systems. We also need to remind ourselves that since no psychotherapist is immune we are all at risk to infection with coronavirus.
So, how should we respond to clients who are first-line responders, exposed as they are both physically, potentially transmitting infection, whilst seeking treatment for their stress-related symptoms, triggered by daily exposure to unprecedented witnessing, and responding to life-death emergency decisions with little or no time for reflection?
They suffer from, or struggle with, well-known overlapping symptoms of moral distress or injury, burnout, relational trauma, and dissociation, or symptoms of simple or complex post-traumatic stress disorder. For decades trauma therapists have been aware of our vulnerability to vicarious trauma. Now, just as exposure risks virus transmission to and from our patients and families, including children, so also with exposure to the two-directional transmission of vicarious trauma and dissociation, with risks of negative iatrogenesis. So how should we adapt our practice to provide a “safe-enough” space for therapy? Beyond the transition to telehealth as part of the safe “social distancing” policy, what additional changes do we need to consider in our therapeutic approach and techniques?
Fortunately Elizabeth Howell's timely new book offers nine enlightening chapters that identify, assimilate, integrate, and detail the relevant issues for clinicians. Howell is well placed to overview the context of the complex historical trends, the legacy of the century-long trauma debate between Freudian “repression” and Janetian “dissociation” to creatively offer a trans-diagnostic resolution to the “mind-body” dichotomy; she reconciles disorganised attachment as dissociation; and provides a parsimonious d