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Trauma

Responding to Fast Trauma and Slow Trauma

Coping with trauma from 911 to COVID-19.

Key points

  • Fast traumas and slow traumas require different coping strategies.
  • Utilizing coping strategies for fast traumas in slow trauma situations can be counterproductive.
  • Flight/fight/fright fast trauma responses increase anxiety during slow traumas like the COVID-19 pandemic.
Image by Geralt at Pixabay
Fast help and slow help
Source: Image by Geralt at Pixabay

When most people think about trauma, they think about unexpected, awful events within a defined time frame. Very fast traumas can be instant, such as getting hit by lightning or a head-on collision.

Fast traumas include being the victim of violent crime or being in a fire. During fast traumas, our bodies and minds experience a rapid and dramatic shift in function. This is sometimes called the “flight/fright/fight” response and corresponds to rapid sympathetic nervous system arousal. This prepares us to rapidly exit a threatening situation or overpower a predator, where escape is impossible.

Slow traumas occur when the traumatic event occurs over a long, potentially infinite, period. Examples are loss of limb, imprisonment, poverty, and the COVID-19 pandemic. In situations of slow trauma, the “flight/fright/fight” response is of no use. There is nowhere to go and no one to overpower. This post focusess on coping mechanisms that are effective in situations of slow trauma.

Coping with fast trauma is facilitated by sympathetic nervous system arousal. Increased levels of adrenalin and cortisol increase our athletic stamina, sharpen our awareness of our environment, and enhance the healing of injuries. This heightened state is best used to flee from predators, dangerous situations, or to fight when one is unable to escape. Once the trauma has ended, either by escape or neutralization, then healing can begin, and growth can resume.

The “flight/fight/fright” response is generally not helpful with slow trauma, but it usually occurs anyway. In traumatic situations where one can neither escape nor fight, the surge of adrenalin associated with the body’s alarm response turns into anxiety. Because there is no tangible threat or target, the nervous system activation tends to come in waves, rather than rapid and strong onset, as with fast trauma. These waves of stimulation can escalate to panic-like states that are often associated with immobilization. This is sometimes referred to as a “deer-in-the-headlights” reaction, which leaves the individual defenseless.

Coping with slow trauma requires overriding the fast trauma response in favor of more adaptive responses. This is an application of Kahneman’s (2011) concept of “thinking, fast and slow.” If you cannot escape or overpower the source of the trauma, then you must make adjustments to be able to live with the trauma as long as necessary, perhaps forever. The following steps will be helpful in coping with slow trauma, like COVID-19.

  1. Accept that the trauma is here to stay. Waiting for a slow trauma to pass is a form of immobilization and disempowerment and encourages feelings of helplessness and increased anxiety. Coping requires that you prepare for change and then make these changes when it is adaptive to do so. You may have to find new ways to get food or to live. You may have to move or find different employment. You may get sick. You must prepare yourself to be flexible and mobile to deal with as many possibilities as you can.
  2. You must first focus on survival. You must secure short-term access to the basics for survival: food, water, shelter, communications, etc.
  3. Things are not “going back to normal.” Disaster is part of evolution, and the world continues to evolve. You must evolve with it. Look at the trauma as a reset, an opportunity to make significant changes that benefit you or others. Be prepared to change your business/work and your family circumstances so that they can survive and function under new circumstances. Telecommuting, take-out dining, telehealth are examples of adaptions to the COVID-19 slow trauma.
  4. Take breaks when you can. You need to rest your body and mind. Reading, exercising, watching a movie are all ways of resting your mind. Thought and introspection benefit adaption, but rumination will increase anxiety and decrease functionality and efficiency. Introspection involves exploring new ways of looking at problems and supports solving them. Rumination is going over the same thoughts repeatedly and it only increases anxiety.
  5. Prepare to be flexible. This means understanding that you will make errors. If you are afraid to make errors, you may become immobilized. COVID-19 has caused us to find new ways to live, work and socialize. These new ways will be unfamiliar, as you have never been in this situation before. No one has.
  6. Help others after you help yourself. Once you have secured your survival, you will be best situated to help others. Helping others works against immobilization and feeling helpless.

Mixed Fast and Slow Trauma

Traumatic events often have both fast and slow components. For example, on September 11, 2001, over 3000 individuals died within an hour when the world trade center was attacked. Individuals in lower Manhattan that day experienced a fast trauma: those who were not killed by the impact of the airplanes on the buildings had to escape the area before the buildings fell on them and before they were enveloped in debris and dust.

The "flight/fight/fright" response facilitated running away from the terror scene as quickly as possible to survive the day. After, several years were spent adapting to a city that was identified on that day as a terror target. The "flight/fight/fright" response was no longer useful and turned into anxiety.

We had to get used to being screened by bomb-sniffing dogs, and we learned to report suspicious activities to authorities. We added metal detectors to public sites such as airports and courts. We are still adapting.

Few individuals get to go through their natural life without trauma. Some survive stronger. Some survive scarred. Some survive broken. Some don’t survive.

Remember the three common human responses to trauma mean:

  • The "flight/fight/fright" response is helpful for fast trauma but cumbersome for slow trauma.
  • Adaptation of oneself to long-term/permanent changes in the environment or life circumstances.
  • Immobilization does not help facilitate coping with traumas of any type.

The ability to use the fast-thinking "flight/fight/fright" response, the slow thinking adaptation response, and the ability to know when to use each one of them may determine whether or not you survive a traumatic event.

We are naturally equipped to cope with both fast and slow trauma, but we must apply these abilities selectively.

References

Kahneman, Daniel. (2011). Thinking Fast and Slow. Farrar, and Giroux, New York City.

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