The journey to becoming trauma-informed - using pilot trauma training data to highlight the role of dental services in supporting patients affected by psychological trauma.

Rates of psychological trauma are increasing in the community. Psychological trauma symptoms may prevent patients from being able to access or tolerate dental treatment. The importance of dental teams providing equitable person-centred care by adopting a trauma-informed approach is discussed. One way to support dental services to be trauma-informed is through training staff in psychological trauma. An example from a Scottish Dental Hospital is provided. Directions for future research are discussed and the next steps in the journey to develop trauma-informed dental services are outlined.

Crisis Psychodrama in the Era of COVID-19.

This work gives an overview of the methods of scenic expression which can be used to help cope with the crisis caused by the global threat of the coronavirus pandemic. The virus is new, the vaccine has not been developed yet and there are no unified prevention and post-prevention policies. In the following lines some modified elements of psychodrama interventions are presented including the ways of preventing the retraumatization of the patient (protagonist). This can be achieved by conscious reliving of the trauma and by activating new, transformative roles to guide the protagonist on his way to recovery.

Processing trauma in psychoanalysis in 'real' time and in dreams: the convergence of past, present and future during COVID-19.

In the current collective unrest, we and our analysands are living in real time and need vantage points from which to make meaning, as subjective experience of time is collapsing. For many analysands, the past is being relived in the present, with no imaginable future. During the time of COVID-19, dreams are providing a valuable mechanism in working with atemporal emotional trauma, previously uncontextualized. Dream metaphor can provide a transitional space to move around in within the analytic framework. This paper explores a variety of dreams from individual analysands demonstrating different ways of conceptualizing personal and collective experience, bridging between the past, present, and future. Parallels between feeling states related to the current condition and unprocessed implicit memories from the past will be examined, as a vehicle for processing past trauma. Dreams expressing current states of dread for an unimaginable future, as well compensatory dreams showing a hopeful vision of the future will be considered.

Dans l'agitation collective actuelle nous-même et nos analysants vivons en temps réel et avons besoin de postes d'observation à partir desquels nous pouvons trouver du sens, alors que notre expérience subjective du temps s'effondre. Pour beaucoup d'analysants le passé est revécu dans le présent et il n'est pas possible d'imaginer l'avenir. Durant cette période de COVID, les rêves fournissent un mécanisme précieux pour travailler sur le traumatisme émotionnel atemporel, jusqu'ici non-contextualisé. Les métaphores du rêve peuvent fournir un espace transitionnel pour évoluer dans l'espace analytique. Cet article explore plusieurs rêves d'analysants montrant différentes façons de conceptualiser l'expérience personnelle et collective, de faire des passerelles entre le passé, le présent et l'avenir. Nous étudierons les parallèles entre les états émotionnels en lien avec la situation actuelle et les souvenirs implicites et non-transformés, envisageant ceci comme un moyen de transformer les traumatismes passés. Nous examinerons des rêves qui expriment des états actuels d'effroi concernant un avenir impossible à imaginer, ainsi que des rêves compensatoires montrant une vision optimiste de l'avenir.

En el malestar colectivo actual nosotros y nuestros analizandos estamos viviendo en tiempo real y necesitamos puntos de vista desde los cuales crear sentido, a medida que la experiencia subjetiva del tiempo está colapsando. Para muchos analizandos, el pasado está siendo revivido en el presente, con un futuro inimaginable. Durante el tiempo del COVID, los sueños están ofreciendo un valioso mecanismo para trabajar con trauma emocional atemporal, previamente no contextualizado. La metáfora del sueño puede ofrecer un espacio transicional para moverse alrededor y dentro del encuadre analítico. El presente trabajo explora una variedad de sueños de analizandos individuales demostrando diversos modos de conceptualizar la experiencia personal y colectiva, creando un puente entre el pasado, el presente y el futuro. Se examinan los paralelismos entre estados emocionales relativos a la condición actual y las memorias implícitas del pasado no procesadas, como vía para procesar el trauma del pasado. Serán considerados, los sueños que expresan estados actuales de miedo por un futuro inimaginable, así como los sueños compensatorios que muestran una visión esperanzadora acerca del futuro.

COVID-19, precarity and loneliness.

In this paper I discuss Jungian psychological work of the trauma and loss experienced in reaction to COVID-19 with a man who represents a clinical composite. The issues of precarity, a concept used by the philosopher Judith Butler, are combined with the notions of lack and absence of French psychoanalyst André Green. The psychological and societal situation of precarity aroused the man's childhood issues that were long repressed. The loneliness, isolation and death from COVID-19 mirrored his personal and the collective responses to the disaster from this global pandemic. He felt on the edge of collapse as what he knew of his world crashed and he found himself unable to cope. The subsequent Jungian work taking place through the virtual computer screen was taxing and restorative simultaneously for both analyst and analysand.

Dans cet article je discute le travail psychologique Jungien sur le traumatisme et la perte dont fait l'expérience un patient en réaction au COVID-19, patient qui représente un composite clinique. Les questions en lien avec la précarité, un concept utilisé par la philosophe Judith Butler, sont combinées avec les notions de manque et d'absence chez le psychanalyste français André Green. La situation psychologique et sociale de précarité a activé les problèmes de l'enfance de cet homme, réprimés depuis longtemps. La solitude, l'isolement et la mort liés au COVID-19 ont fait miroir avec ses réponses personnelles et les réponses collectives au désastre de cette pandémie globale. Il se sentit à la limite de l'effondrement alors que ce qu'il connaissait de son monde s'écroulait et il se trouva dans l'incapacité de faire face. Le travail Jungien qui s'ensuivit, au moyen de l'écran virtuel de l'ordinateur fut éprouvant et réparateur pour l'analysant et l'analyste simultanément.

En el presente trabajo, describo el trabajo psicológico Junguiano, con un hombre que representa un compuesto clínico, acerca del trauma y la pérdida experimentada en reacción al COVID-19. Cuestiones de precariedad, un concepto utilizado por la filósofa Judith Butler, son combinadas con las nociones de falta y ausencia del psicoanalista francés André Green. La situación psicológica y social de precariedad activa temas infantiles del individuo, hasta entonces reprimidos. La soledad, aislamiento y muerte del COVID-19 espejó la suya personal y las respuestas colectivas al desastre de esta pandemia global. Él se encontró en el borde del colapso debido a que lo que él conocía del mundo se quebró, y se encontró imposibilitado de hacer algo con esto. El trabajo Junguiano subsiguiente que tuvo lugar a través de la pantalla virtual de la computadora fue arduo y restaurador simultáneamente para ambos, analista y analizando.

A trauma-informed approach to the pediatric COVID-19 response.

To effectively care for children during COVID-19, pediatricians need to appreciate the stress and potential traumatic effect of the pandemic. By employing the "CARES" framework, pediatric providers can openly discuss the pandemic with patients and families, collaborate to build resiliency, and encourage engagement in activities and resources that are protective. This approach could potentially prevent both the short and long term health consequences resulting from the toxic stress and traumatic exposure of COVID-19. Pediatricians are uniquely positioned to mitigate the extent to which the pandemic affects the nation's children and we believe it is our responsibility to do so, to uphold the health and wellness of pediatric patients across their lifespan.

Addressing mental health in patients and providers during the COVID-19 pandemic.

The pandemic, and the associated changes to pregnancy and postpartum experiences, can lead to profound psychological reactions including panic, hyperarousal, sleep disturbance, anxiety, depression, and traumatic stress disorders. Providers face compassion fatigue and shared trauma. In this article, we describe the mental health outcomes known to date in regard to the novel coronavirus disease 2019 pandemic for obstetric patients and their providers as well as therapeutic approaches, including our novel embedded mental health service, to address these mental health needs.

Paramedics in pandemics: protecting the mental wellness of those behind enemy lines.

Besides a global health crisis, the COVID-19 pandemic has potential to have a severe and long-lasting psychological impact on frontline healthcare workers such as paramedics. It is imperative to shed light on these mental health issues and employ interventions to protect the mental wellness of this vulnerable group of healthcare workers.

Children and the COVID-19 pandemic.

As a result of the COVID-19 pandemic, many school districts have closed for the remainder of the academic year. These closures are unfortunate because, for many students, schools are their only source of trauma-informed care and supports. When schools reopen, they must develop a comprehensive plan to address the potential mental health needs of their students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Developing thinking around mental health science: the example of intrusive, emotional mental imagery after psychological trauma.

INTRODUCTION: One route to advancing psychological treatments is to harness mental health science, a multidisciplinary approach including individuals with lived experience and end users (e.g., Holmes, E. A., Craske, M. G., & Graybiel, A. M. (2014). Psychological treatments: A call for mental-health science. Nature, 511(7509), 287-289. doi:10.1038/511287a). While early days, we here illustrate a line of research explored by our group-intrusive imagery-based memories after trauma. METHOD/RESULTS: We illustrate three possible approaches through which mental health science may stimulate thinking around psychological treatment innovation. First, focusing on single/specific target symptoms rather than full, multifaceted psychiatric diagnoses (e.g., intrusive trauma memories rather than all of posttraumatic stress disorder). Second, investigating mechanisms that can be modified in treatment (treatment mechanisms), rather than those which cannot (e.g., processes only linked to aetiology). Finally, exploring novel ways of delivering psychological treatment (peer-/self-administration), given the prevalence of mental health problems globally, and the corresponding need for effective interventions that can be delivered at scale and remotely for example at times of crisis (e.g., current COVID-19 pandemic). CONCLUSIONS: These three approaches suggest options for potential innovative avenues through which mental health science may be harnessed to recouple basic and applied research and transform treatment development.

Addressing trauma and stress in the COVID-19 pandemic: Challenges and the promise of integrated primary care.

Integrated primary care settings are ideal locations for treatment of posttraumatic stress concerns as primary care is the principal access point for mental health treatment in the United States. The COVID-19 global pandemic will increase the necessity of posttraumatic stress-related psychological care for vulnerable populations and frontline providers through traditional and virtual methods; integrated primary care settings are rapidly adapting to meet this need. Integrating more behavioral health clinicians into primary care clinics will provide better access to whole-person care when it is needed most. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The rise of adverse childhood experiences during the COVID-19 pandemic.

Adverse childhood experiences, which is defined by different forms of abuse, neglect, and household dysfunction occurring before the age of 18 years, is a major public health problem in the United States that has the potential to worsen in the current COVID-19 pandemic. Moreover, the challenge is even greater for children and youth from low-income communities and communities of color. Thus, there is a greater need for investments in youth-serving systems within and beyond health care and public health to effectively address adverse childhood experiences and prevent its short- and long-term negative health and social sequelae well beyond the current public health crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Defining trauma and a trauma-informed COVID-19 response.

The ubiquitous exposure to COVID-19 argues for governments to use a trauma-informed response as a universal precaution, with the goal of promoting the recovery and resilience of their residents. How a system defines trauma will drive its administrative policies, research, and clinical services. The Substance Abuse and Mental Health Services Administration's Concept of Trauma and Guidance for a Trauma-Informed Approach offers governments a framework to define trauma and incorporate trauma-informed principles and tasks into their COVID-19 responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A model for treating COVID-19-related guilt, shame, and moral injury.

During the unprecedented COVID-19 pandemic, people around the world have faced a myriad of heart-rending and ethically difficult scenarios (e.g., not being able to tend to a sick or dying loved one) that may lead to subsequent guilt, shame, or moral injury. Trauma-informed guilt reduction therapy is a brief intervention that helps clients accurately appraise their role in a stressful event (such as those experienced during the COVID-19 pandemic) and find positive ways to express important values going forward. Future studies of trauma-informed guilt reduction therapy with those affected by COVID-19 will be helpful for clarifying its effectiveness with this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The outbreak that was always here: Racial trauma in the context of COVID-19 and implications for mental health providers.

The present commentary offers a timely exploration of the racial trauma experienced by Asian, Black, and Latinx communities as it relates to COVID-19. Instances of individual, cultural, and structural racism and implications for mental health are discussed. Evidence-based strategies are identified for mental health professionals in order to support healing and mitigate the risk of further racial traumas. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

LGBTQ populations: Psychologically vulnerable communities in the COVID-19 pandemic.

In the wake of the 2019 novel coronavirus (COVID-19) pandemic and the psychological consequences that will follow, it is critical to acknowledge and understand the unique vulnerabilities of lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) populations in order to provide equitable mental health intervention that reaches these highly at-risk groups. It is well established that LGBTQ persons face social disadvantages and mental health disparities, which may be exacerbated as a result of COVID-19 pandemic trauma and social isolation measures. This commentary highlights structural, social, and individual-level challenges among LGBTQ populations in the context of COVID-19 and proposes prevention recommendations to mitigate the psychological ramifications of COVID-19 pandemic-related trauma among LGBTQ persons. (PsycInfo Database Record (c) 2020 APA, all rights reserved).