Image: iStock/ShaniMiller
We’ve all been born into collective trauma. Our work is to integrate unhealed wounds that chronically affect our emotions, minds and bodies.
This was one of the takeaways from a recent Harvard Longwood Campus Office of Employee Development and Wellness virtual workshop series focused on building resilience through self-regulation, coregulation and group coherence.
Approximately 50 attendees, including faculty, researchers, clinicians and staff from Harvard schools and affiliated hospitals attended the three-part series in May and early June.
Teaching the workshop from his home office in Tel Aviv,Thomas Hübl, anauthor and facilitator who has promoted international dialogue on collective trauma, invited workshop participants to investigate both the sources and symptoms of trauma in their lives.
The first step, he said, is to understand how each of us self-regulates when faced with stress.
“We are used to high, chronic stress levels, accumulated over decades, that we don’t even call stress anymore,” Hübl said.
To carry the stress, we’ve suppressed the emotions that led us to this state, he said. And to protect ourselves from the intensity of feelings stored inside, we mentally interpret our emotions, instead of expressing them and sensing how they impact our minds and bodies.
Ultimately, Hübl suggested, unresolved stress can disrupt a sense of wholeness within ourselves.
“The more we pay attention to this invisible fragmentation within ourselves in our daily lives, the more we can identify and resolve these patterns before they become chronic,” he said.
Through a guided meditation that focuses on identifying emotions and sensing blocks in the body,Hübl suggested that witnessing how fragmentation first appears is an important step when trying to understand, and contribute solutions to, larger societal disruptions and unrest.
Carrying collective trauma
“As physicians, we don’t have the structure and space to dig into trauma,”said one of the workshop participants, Kristen Schaefer, a palliative care physician at Dana-Farber Cancer Institute and assistant professor of medicine at HMS. She said that a conversation about trauma was timely for her.
“There’s a bravado about not having trauma. Psychiatrists and social workers have a culture to navigate that, but there’s a loneliness in being in another specialty that doesn’t have this rich landscape to work with trauma,” she said.
Schaefer has treated patients who have experienced collective trauma and has been an advocate for palliative care medical education.
She currently teaches a longitudinal development course for first-year medical students. The course offers students skills to cultivate a reflective practice to accompany the rigor of their clinical training.
Like many physicians, Schaefer has juggled the demands of attending to her patients’ fears and increased needs during the pandemic, while managing her own stress and her family’s.
“As I’ve cared for my patients and students during the COVID-19 crisis, I’ve been seeing in myself, students, family, peers this kind of trauma. I’ve been thinking about who I can be as a teacher, colleague and physician within this framework of understanding trauma,” she said.
She said she appreciated Hübl’s humanistic approach.
“You have to really practice seeing what trauma is, and not react to it, but try to enter people’s experience of it,” she said. “Seeing others step up and name a kind of deep brokenness and then offering a format to collectively approach it feels essential to healing.”
In 2016,Hübl founded a nonprofit organization called the Pocket Project to address these questions. Last December, hespoke at Harvard Medical School about his approach to examining systemic collective trauma at a Talk@12,in conversation with Bala Subramaniam, HMS associate professor of anaesthesia at Beth Israel Deaconess Medical Center.
His forthcoming book, Healing Collective Trauma: A Process for Integrating Our Intergenerational and Cultural Wounds, is scheduled for publication in November.
Creating group coherence
Achieving self-regulation is possible by aligning one’s emotions, thoughts and somatic awareness, according to Hübl. He said the process is aided and complemented by co-regulation, which is allowing resonance to happen with another’s nervous system.
“What the pandemic has taught us is that we are all interdependent. The state of a mature human being is the recognition of our interdependence,” Hübl said.
There are opportunities to practice this in the workplace, he pointed out, where coworkers often face a choice: create emotional distance when we don’t want to feel other people’s stress or invite them into the possibility of emotional resonance by listening, which can then spark our true capacities as leaders.
“The latter approach, I believe, builds a much higher level of trust. But it’s more challenging because it means that I have to be willing to feel, in an authentic way, the stress of people in my environment,” Hübl said.
As we practice this on our teams, we strengthen our relational competencies and our ability to support one another during times of stress and crisis, he said.
Other initiatives have also focused on this area of research at the University. At Harvard College, a course on the political implications of collective trauma was offered in 2016-17 by sociologist and lecturer Shai Dromi, who also attended the trauma workshop.
Coping with layers of trauma
For the past 40 years, the Harvard Program for Refugee Trauma at Massachusetts General Hospital has also been providing services for refugees and conducting research.
Program director Richard Mollica, who attended the Hübl workshop, commended his own staff and patients for how they’ve dealt with heightened trauma among patients in recent months as they face financial hardship and uncertainty.
“In our clinic, I’ve been seeing patients for years who have been tortured and lived through genocide and trauma from Afghanistan, Iraq, Cambodia and other countries. There’s a protective factor, a kind of ‘bubble’ that’s been created around traumatized people who have been in treatment all these years, which has protected them from the current pandemic,” he said. “They’re safe at home. We’re able to reach them. They don’t miss their appointments online. They have a close relationship with us. I’m very proud of how well they are doing.”
The author of the book “Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World,” Mollica is currently writing about COVID-19 as a shared collective experience that impacts all living beings.
He’s particularly concerned with the pandemic’s toll on infected health care workers in the U.S. — who include certified nursing assistants and others.
“We have to arrive at the point where the trauma story is told at every hospital, every nursing home, every veterans’ center, every homeless shelter,” said Mollica. “The collective trauma of this virus and its impact on health care workers has to be told; we have to bear witness to these great and wonderful people who have taken back medicine.”
When health care professionals at all levels suffer at work with unresolved trauma, their patients also suffer, he said.
“If our health care workers cannot come to terms with their own trauma story, why would they want to listen to the patients? Listening, understanding and deep appreciation on both sides is key to creating healing relationships, as well as self-care,” he said.
Experiential workshops on resilience
Offering workshops that elucidate the research on trauma and resilience while introducing attendees to coping practices was the aim of this workshop series, said Adriana Robertson, training and development program manager at Harvard Longwood Campus (HMS, Harvard Chan School and Harvard School of Dental Medicine).
As the Harvard community moves into the third month of the pandemic and continues to experience high levels of uncertainty and change, the Center for Workplace Development and the Harvard Longwood Campus have partnered to design a new series of workshops beginning on June 17.
“Things have been so bleak and so painful; there’s so much suffering going on,” saidAlexis Griffith-Waye, who serves as the director for the Center for Workplace Development and is writing and co-facilitating the new series.
Through research and hands-on experience as a facilitator, Robertson has come to define resilience as “our ability to see challenges and obstacles as opportunities for learning and growth, and to see the potential in whatever is showing up in our lives.”
And the benefits of resilience manifest in the larger community and to the University as a whole, she said.
“The research has been clear: you start to see innovation skyrocket; performance, engagement, connection all go up. And from an organizational standpoint, sick time declines as resilience increases,” she said.
The workshops will also approach the topic through a holistic lens, focusing on what the facilitators have identified as five essential components of resilience: optimism, mental agility, self-awareness, self-regulation and connection.
“I know the University is extremely large, but our size can be a strength if we move forward together in supporting one another through this challenging time,” said Griffith-Waye.
Taking care of the Harvard community
Nancy Costikyan, director of the University’s Office of Work/Life, juggles many priorities in supporting the well-being of staff and faculty.
Costikyan believes that fostering resilience through this pandemic is not just a short-term prospect but is integral to the long-term sustainability of the Harvard community.
“There are distinct psychological stages of a sustained collective crisis, just as there are for individuals with personal trauma,” she said.
“While some people experience severe impairment, most people move through that impairment, adapt and recover from adverse experience,” she said.
“Both groups can be considered resilient, but they may be on different timetables. Because we are all experiencing this crisis at the same time but have a range of responses … we may be out of synch with each other. I’m very interested in how these phenomena affect the collective,” she said.
Resilience can be expressed in different ways at different times, Costikyan added. A meaningful assessment of resilience includes a holistic examination of the way people deliver themselves to the world.
Pointing out that resilience is not something you can learn in a weekend workshop, Costikyan said that resilience is about integration.
“How one integrates all experiences, including those that are profoundly adverse, and recovers from them and even grows, is what is sometimes called post-traumatic growth. That is one of those beautiful markers, I believe, of resilience.”
The first workshop in the new series, Building Personal Resilience: Optimism, will take place on Wed., June 17, from 10 a.m. to noon, with a second workshop on Building Personal Resilience: Mental Agility on Wed., June 24, at 10:a.m., followed by two more workshops in July.
