You finally rush out the door 20 minutes after your shift, sorting through your mind to see if you handed off all the things you needed to. You can finally breathe openly without a mask on, and as you buckle in and badge out, instead of the tunes or podcasts you normally go to, you soak in the silence. The image of the body lying there on the bed, the sounds of the family crying, the tension you were holding in your shoulders, back, or the pit of your stomach. You might not be at work, but your body and mind are. Maybe it was your 4th Covid patient to die that day, and you helped to Facetime their family. Maybe it was the child who committed suicide, who happens to be the same age as your child. Maybe it was the cancer patient who is leaving a single dad to fend for himself and the kids. For many of us, death becomes second nature, a routine, that we have mentally grappled with already. But there is always that one that sneaks up on you, that you can’t shake at shift change. So you drive home, on autopilot down the same streets you always take, trying to make sense of the nonsensical.

If there is one thing medical professionals are expert at, it is divorcing themselves from their emotions. I mean, what good would it be if every time we were faced with a devastating car wreck, or new diagnosis, we also broke down in tears. We listen, we validate, we offer that we “can’t imagine”, and we separate from our emotions, to do our jobs. So it probably doesn’t come naturally for many of us, while driving home, to lean into what those feelings are that we have intentionally pushed aside. Is that sadness for the patient and their family, anger that there wasn’t a different outcome, fear that you are vulnerable to the same things they were? And even beyond allowing our emotions to surface, what do these experiences say about our worldview? How do they shape the beliefs we hold about ourselves: I’m not good enough, I’m not safe, I have no control.

We get home and we vent, to our spouse, our roommate or our sister. We share the devastation to get validation from someone else that what we are doing, what we are seeing, is not normal. Then we have a drink, or take a shower, and probably both. And do it all over again. For so many of us, the processing stops there. We continue to accumulate battle scars, and the seepage into our lives is so slow that we may not notice it at first. We might be hypervigilant about our children, we might have a transient chest pain we can’t get off our minds, we might not be able to offer our husband or friends empathy for things that we perceive to be “small” issues. We might pull into work with resentment, or get frustrated with colleagues without even really knowing why.

We have all heard many times the advice to put on our own oxygen masks first, to take care of ourselves before we can take care of others. We have probably given this advice to caregivers at the patient’s bedside many times. But we know their work won’t end there, and the real work for the caregivers will start at home. This is the piece we are all missing. Our real work starts at home too. Self care doesn’t mean regulating our emotions enough to get back to work the next day. The real self care is recognizing that what we are experiencing as healthcare professionals is trauma, and often a cumulative trauma, that is going unprocessed for months and years on end. The real self care is recognizing that in order to be the people that we want, the friends, parents and spouses that we want, the colleagues that we want, the providers that we want, we need to process what we have been through more fully than a silent ride home, or a glass of wine before bed.

EMDR, or eye movement desensitization and reprocessing, is an evidence based treatment method that involves processing the images, emotions, beliefs and body sensations surrounding the traumas that we experience. I know as a healthcare professional it’s normal to be discerning about the treatment type you are engaging in, and it may help to review the data. https://www.emdria.org/ is the EMDR international organization that certifies practitioners, and also has a wealth of knowledge about what EMDR is, what it is like to experience it, and what the research is showing it can help with. EMDR sessions can be done in standard 50 minute sessions, or through EMDR intensives. Intensives are longer sessions (think several hours) that occur less frequently (sometimes monthly) which some medical professionals may prefer due to having busy schedules and difficulty finding the time to schedule weekly therapy. If you are a candidate for intensive sessions, they are just as effective as shorter sessions and may allow for relief from trauma symptoms in a more compressed format.

One healthcare worker who has engaged in EMDR treatment with their therapist has been kind enough to allow me to share their experience. They said “At first I was super skeptical about EMDR because I wasn’t quite sure what to expect, but it has been so helpful professionally and personally! It definitely is a little strange at first and other people really don’t understand it unless they have been through it as well. But once I started, I could immediately feel the positive effects. I have a safe place to process old cases that I have never really been able to talk about before. EMDR has helped me have closure to hard cases, process really intense cases, and ultimately be a better healthcare professional because the weight I carried from these previous cases has been lifted.”

As a therapist who has worked for decades in the medical setting, I understand that you have likely experienced many things that people outside of the healthcare world likely can’t imagine. You can unburden yourself of the scars you have accumulated over time, and develop the skills to leave work at work. If you would like to learn more about EMDR and how it can help you during these overwhelming times, please reach out to me at stephanie@eastatlantacounseling.com or via phone at 404-585-7599. I also have an Instagram tv series about EMDR available on my Instagram account stephanieblcsw, and a newsletter sign up at www.eastatlantacounseling.com

Trauma Processing for Healthcare Workers