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Friday, March 20, 2020

Guilt and facing the coronavirus: A guide for professional helpers and healers experiencing traumatic countertransference

Nurses, physicians, advanced practice providers, and other caregivers are now facing overwhelming odds and experiencing not only their own fears, but also guilt. They must face not only patients whom they cannot serve adequately because of a lack of resources, but then must return home with the worry that they are potentially infecting family, friends, and neighbors they encounter. The danger in these experiences is to psychologically develop traumatic countertransference, which occurs when caregivers are faced with insurmountable odds and actually try to meet people's unrealistic expectations. The result is feelings of guilt and even anger over the inability to meet them. As caring persons, they do their best to meet the impossible demands of those who came for help.

In traumatic transference, people project their sense of helplessness and hopelessness and communicate it in many ways, including sadness and anger. The negative feelings aren't really about any one person; they are a reaction to the situation. No one else can truly understand the unique situation and all the stresses they experience. Two important things that can help in these times of crisis are friendship and prayer (or in secular terms, a sense of "mindfulness"). Something else that is essential to remain faithful as a caregiver in overwhelming situations is the ability to let go. 

As a nurse, you can only do what you can with those you serve. You can only protect yourself physically as much as possible before returning home to those you love. If you step back from your role because of guilt, over-responsibility, or the anger and pain of your patients, this is understandable. Don't pick on yourself; you have given so much you don't deserve such bad treatment—especially from yourself!   

On the other hand, if you can remain in the fray through keeping in mind and addressing the psychological dangers to you, you will be pure gift to those who need you—not simply for the physical care you offer but, of equal importance, in being able to remain with others when all you can provide is a sense of presence at a time when it is dark for patients, family, and even yourself. One of the greatest gifts you can share with others during those times is a sense of your own peace and a healthy perspective, but you can't share what you don't have. And so, be clear, but also very gentle in how you view and treat yourself. Guilt is understandable at times but, in the end, it is a waste of energy and becomes problematic not simply for you, but for those you serve and live with because the self is limited and when the resiliency reservoir is emptied, no one wins. 

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Dr. Robert J. Wicks is the author of Perspective: The Calm within the Storm, Overcoming Secondary Stress in Medical and Nursing Practice, and co-author (with Mary Beth Werdel) of A Primer on Traumatic Growth.