Welcome to The Undark Podcast, which will deliver — once a month from September to May — a feature-length exploration of a single topic at the intersection of science and society. In this episode, join news, health, and culture journalist Elna Schütz and podcast host Lydia Chain as they hear from researchers and therapists examining the psychological impacts of Covid-19 through the lens of collective trauma.
Tracy Feinstein: I think that people are definitely going through trauma. And what I find is that the experience is so unique for each person. … But we are seeing that everything that has happened externally now is really affecting us. I mean, I’ve even felt it.
Elna Schütz: This is Tracy Feinstein, a volunteer counselor for SADAG, the South African Depression and Anxiety Group.
For the last seven or eight years, she has worked with the group in different ways, mostly as a volunteer for their hotline to listen to people’s problems and try to support them. This year, amid a global pandemic, her work has changed. The people calling her are having a harder time, and she’s hearing common threads between their experiences, and also her own.
Tracy Feinstein: I live alone. I would consider myself quite a strong person. I’ve got my stuff together. And if I take what I’ve had in my whole life, I would say, I’m cool. And I’m really, okay.
Elna Schütz: Despite this, Feinstein found herself reacting really strongly to small things, like when she sent a Zoom link for an intimate call with a friend to several people accidentally.
Tracy Feinstein: That triggered me completely in that I was stressed out. I burst into tears. It really was like a mini panic attack. And it’s not my kind of behavior, you know? And that’s kind of what I’m seeing coming through with the callers, is people are, they’re starting to use the terminology and saying, I think I’m having an anxiety attack or I think I’m, I’m really stressed out or I’m battling with depression, and when you talk to them on the phone, you begin to realize there’s nothing extreme happening in their life. It’s part of the new normal during lockdown.
Lydia Chain: This is the Undark podcast, I’m Lydia Chain. Sometimes a community goes through something so traumatic that the event leaves a societal scar. It’s not just the sum of each individual person’s struggle with their own private trauma — it’s bigger than that.
Psychologists call this collective, or communal trauma, and it can impact the psyche and culture of the group itself, sometimes spanning generations.
As the Covid-19 pandemic is unfolding, so are the psychological effects. Some of these effects, like anxiety over a job, or grief over a lost loved one, impact individuals. But collective trauma researchers say this is the kind of event that will have widespread and long-lasting impacts on society. They are trying to study and ease this trauma as it unfolds, all while suffering through the pandemic themselves.
Elna Schütz has the story.
Elna Schütz: The SADAG helplines are manned by a variety of people, including psychological professionals like registered counsellor Cayley Jorgensen, who also has a private practice. And she says not only are more patients reaching out to her, but the calls are more intense.
Cayley Jorgensen: Suicide calls have increased hugely. In my private practice away from the SADAG lines as well, suicide is huge at the moment. And it’s almost that feeling of not in control of the situation. So much has changed. And that, you know, relates for all different demographics in South Africa. It’s a change in nature of calls, but also a change in the aggravating factors of the call itself.
Elna Schütz: Jorgensen says that previous traumas are also compounding people’s mental health struggles.
Cayley Jorgensen: Gender-based violence has increased hugely in South Africa during this lockdown and during the Covid pandemic, which has increased the PTSD that individuals are feeling, you know, just in terms of previous traumas that they’ve gone through, which have now been re-triggered by certain incidents as well as now new triggers.
Elna Schütz: These new triggers are manyfold. Like much of the world, South Africa was hard-hit by the pandemic and clamped down to try to control it. A hard lockdown over several months meant almost no freedom of movement except for essential tasks and even a ban of the sale of alcohol and tobacco. There were also significant job losses, with over 2 million South Africans losing their employment between April and June.
Cayley Jorgensen: You can’t go out. You can’t go anywhere. You can’t see any of your friends. You can’t drink alcohol, as well as the financial pressures. Literally, you’ve got people now who are not able to smoke, that trauma is huge as well. I’m fortunate enough that I don’t live alone, but a lot of callers do. And that aloneness was huge to try and understand.
Elna Schütz: Amina Mwaikambo is a psychosocial and trauma professional at the Center for the Study of Violence and Reconciliation — the CSVR — in Johannesburg. She’s used to working with traumatized migrants and even torture victims.
Amina Mwaikambo: Typically, when you’re working with people, you’re challenging them to face the hard parts in their life so that they can go through it, they can understand it, they can make meaning of it.
Elna Schütz: Like Feinstein and Jorgensen, she says that one of the challenges of being a mental health professional during this time is that she’s sharing the experience with her clients.
Amina Mwaikambo: And essentially, there have been times when we’ve had to sit with the discomfort, we’ve had to sit with the inability to do what you want to do, the inability to make meaning of something right now.
I mean, I’ve never been a therapist in a pandemic. So this is also new. But I’ve had to then sit and say, this is uncomfortable. Here, I don’t feel like I know exactly what’s happening. It’s been quite a big learning curve, that life is, for the most part, quite unpredictable.
Elna Schütz: Everyone has been affected. Because this pandemic isn’t just causing lots of individual separate experiences of trauma, many psychologists think there’s something bigger.
Nomfundo Mogapi: Elna, can you hear me? Just lost you for a minute, yes.
Elna Schütz: Nomfundo Mogapi is the executive director at the CSVR. She took my call from her car for a little quiet. The pandemic had hit her family, and she was out of town for the funeral.
Nomfundo Mogapi: I’m very passionate about, you know, my country and my continent and I can see how asleep we are to this. I can see the trauma all around me, but yet I know that I can’t reach out to everyone.
Elna Schütz: Mogapi has been studying trauma for years, but at a different scale than the kind of individual trauma that the counselors described earlier. Collective trauma is when an event or change in the society is so damaging that it changes the group itself.
Nomfundo Mogapi: So the idea of the collective trauma comes from an understanding that just as much as individuals can be traumatized, which is usually the perspective within the post-traumatic stress disorder field, there is an increasing acknowledgment that collectives can also be traumatized.
So, this could be at a family level, community level, societal level. And now we are even learning that you could as a whole world actually — based on what we are seeing with the pandemic — be able to have a collective trauma.
Elna Schütz: You see, trauma — of any kind — isn’t just about the fact that something bad happened, but how it affects reactions and behavior long-term.
Nomfundo Mogapi: We enter the territory of collective trauma, when there is this sense of a shared experience that we are all experiencing this together. And it actually manifests itself in most of our conversations, whether it’s in the media, how we talk to each other, how we engage with each other, how we deal with societal issues.
Elna Schütz: Think about it this way: Someone who was traumatized in a situation with a gunshot may react badly to balloons popping or doors slamming, even years later when the threat is gone. Small things represent the big thing from the past.
With a collective trauma, the same thing happens on a larger scale. The theory has been applied to things like the Holocaust and 9/11. And here in South Africa, the Apartheid system stripped one group of people of their dignity and rights and gave all the power to the other group.
Mogapi gives an example of how the past collective trauma can be seen during the pandemic.
Nomfundo Mogapi: So one of the key issues of our historical trauma was this concept of othering. And we are seeing it now: I mean, the stigmatization of people who test positive, the othering of “I cannot trust you,” the deepening of xenophobic issues that we had in the past. Race is playing it’s part also because the people in the townships are saying, “Yeah, it’s the White people and the rich that are bringing this thing to us because we don’t travel.”
Elna Schütz: Mogapi says these narratives of past trauma can become part of how a community relates to itself longer term, from social media to personal interactions.
Nomfundo Mogapi: You could have a traumatic event, where people have experienced extreme losses, but they have never really mourned the loss or dealt with the loss and when that loss and that painful experience has not been processed, then it becomes a collective trauma and a chosen trauma for that particular group, and this can be transferred from one generation to the next. Where I mean, in South Africa, we talk about Apartheid is a particular chosen trauma that has now been transferred to our children, and is going to be transferred to the next generation until we find a way to be able to deal with it.
Elna Schütz: Mogapi speaks about chosen trauma, which is a subcategory of sorts to collective trauma theory. This of course doesn’t mean that a group chose to experience a trauma, but just that a particular event has long lasting effects because it hasn’t been dealt with. This could happen with the Covid-19 pandemic in that it becomes a pain or trauma that the society keeps referring back to and not healing from the negative consequences. But Mogapi says that the world is also likely going to develop another type of collective trauma called cultural trauma.
Nomfundo Mogapi: And there’s a school of thought that talks about cultural trauma. And this one really focuses more not just on a chosen trauma that has not been mourned, but the nature of change. That there are certain experiences and changes that are so quick and so rapid, that they completely change the culture of a certain society. And that results into cultural trauma.
And I mean, definitely, if you look at Covid-19, that is exactly what it has done for us. You could look at it resulting into this cultural trauma. It’s like everything we’ve known around how to be in the world, all the assumptions that we’ve had about how the world is supposed to interact have just been pulled under our feet, and we don’t know where to stand.
Elna Schütz: Think back to all of the individual examples the counselors gave earlier and how the pandemic has changed normal ways of being. The government took greater control, information about the disease was rapidly changing and at times confusing, and social interactions changed because they could be medically dangerous.
The specific manifestation of this cultural trauma may only be clear looking back in years to come. But other collective traumas have shown that the effects can linger over several generations.
Gillian Eagle: I think one of the issues about the coronavirus and the Covid pandemic is that there is a sense that actually nobody is immune from infection.
Elna Schütz: This is Gillian Eagle, a psychology professor at the University of the Witwatersrand. She has been looking at how trauma and violence exist in South Africa since the 80s, and she was one of the people to develop the Wits Trauma Model, which is a framework still used today in the treatment of individual trauma cases.
Gillian Eagle: Nobody can completely necessarily protect themselves from becoming infected and they can’t entirely predict what the outcome of that will be in terms of severity. So, really, I think people are carrying an enormous amount of anxiety.
Elna Schütz: Eagle says that this kind of anxiety, which interlinks with collective trauma, is also called Continuous Traumatic Stress, which describes the psychological impact of living with a realistic threat of continued danger, rather than just the experience of a past threat.
Over the last few months, this has been there constantly in the background of the nation’s psyche. As individuals and as a society, people are bracing for long-term effects.
Gillian Eagle: But in addition to that, I think there is something about the sense of having to endure something which you have no real control over in terms of when that period of time will end. That is also creating in people a response that’s probably closer to something like burnout in the sense that when people are developing fatigue, irritability, that their ability to go on being kind of cheerful, optimistic, or phlegmatic, or supportive of other people is kind of wearing out a bit.
Elna Schütz: While there may be some comfort in a shared experience, even in a trauma, Eagle says it can also make it harder for someone to seek and get support from their network, since everyone is already burdened.
She also notes that the traumatic event can divide a society even further.
Gillian Eagle: One of the things I think one has to take account of is that I think at the same time that we are all being affected, Covid is also contributing to divisions in society, so both globally and locally. So while we share the anxiety around being infected, the harm that comes to people who gets infected, the disruption to lifestyle, I think in South Africa, it’s also highlighting a lot of the divisions in society in relation, particularly to wealth and poverty and who can keep themselves protected from the virus more easily than people for example, who have to use public transport or live in circumstances in which it’s almost impossible to physically isolate.
Elna Schütz: Eagle says that in the early days of the pandemic, there was a sense of solidarity and hope in the country. By mid-July, South Africa was in the top five countries in the world in terms of confirmed cases and she says as the country reached its infection peak, the psychological effects deepened.
Gillian Eagle: I wrote to someone the other day, I feel like I’m running an endurance race that I didn’t sign up for in the first place. And I don’t know when it’s going to end. And I think people are still trying to draw on that sense of resilience. But I think we started off from a low base that actually, you know, sort of, to overgeneralize, but I think South Africans in general were already somewhat disillusioned, somewhat battered a bit, by the socioeconomic and political issues in the country.
Elna Schütz: Eagle is implying that the pandemic is cutting deeper into divisions in the society, and perhaps even making the hardships more difficult to deal with. Mogapi says this can be seen in how South Africans are reacting to the pandemic.
Nomfundo Mogapi: What we are seeing is that Covid-19 has exacerbated already existing problems in a number of societies. In CSVR, we have been talking about fault lines of our democracy, which were really sort of unresolved issues of the past and we are seeing increased sort of conflict between the citizens and governments. There’s just complete lack of trust. Anything that’s been done is looked at with suspicion. It therefore becomes difficult for us to have a social contract around how to respond to Covid-19.
Elna Schütz: Researchers like Mogapi and Eagle have understood collective traumas looking back at them, but this one is unfolding right now. Some psychologists are just beginning the process of studying the effects of pandemic-related trauma, beginning with individuals
For instance, The WorkWell research unit at North-West University and its commercial arm, Afriforté, have studied signs of pre-traumatic stress since April, and have created tools that employers can use to support their staff. They collaborated with SADAG for parts of this work.
Pre-TSD is when someone shows classic PTSD symptoms, before anything has happened to them. Afriforté’s managing director, Ina Rothmann, explains some of what they saw in a sample size of almost 1,700 people.
Ina Rothmann: What we found is that compared to the norm — and these are all employed people — 46 percent of the sample were at high risk of pre-traumatic stress. And for 28 percent of the sample, pre-traumatic stress symptoms are combined with stress-related physical ill health symptoms.
These individuals are particularly at risk of future mental health and physical health risks, you know, such as depressive disorders and changes in blood pressure, blood glucose, and cholesterol levels, making them more susceptible for heart disease and diabetes and even obesity.
Elna Schütz: So, almost half of people were showing signs that they were at high risk of pre-TSD and psychological distress. This wasn’t just a mindset, their bodies were showing symptoms like headaches and sleep problems, because of this stress.
But Rothmann and the team weren’t just looking at negatives. They found that despite all of this, only a small amount of the sample were experiencing total despair.
Ina Rothmann: We confirmed the protective effect of hope on stress experiences, because as hope levels increase for this sample, experiences of pre-traumatic symptoms decrease.
Elna Schütz: Rothmann concluded from her research that people who were able to focus on positive things did directly experience less negativity. Again, this research wasn’t about collective trauma but rather the individuals, but she says it’s an indicator that something collective is unfolding.
Ina Rothmann: And this is such an important finding, meaning that if we can encourage hope in these times, such as normalizing fears, and emphasizing the non-permanency of our current situation, we can mitigate pre-traumatic stress experiences, and perhaps protect the future mental health of people.
Elna Schütz: Rothmann’s findings share a similar theme to Mogapi’s extensive work in collective trauma for the Center for the Study of Violence and Reconciliation about what could help a collective heal.
Nomfundo Mogapi: Those doing neuropsychology talk about you know, the elasticity of the brain and the capacity of the brain, when the right things are put in place to actually recover even from what is considered to be the most horrendous experiences. But there’s a number of things that need to be in place.
Elna Schütz: She says the first is an awareness of the collective trauma — acknowledging what has happened and what has changed. And governmental and community leadership is critical. For instance, she says if grieving families were better informed of restrictions around funeral size, these changes may be easier to handle.
Mogapi is working with government structures on resilience and mental wellbeing programs, but she says the healing happens on every level of leadership.
Nomfundo Mogapi: If we can start with leaders and families, we would have already done a lot of work, because when leadership is healed, they have the capacity to make the traumatic experience bearable. They can become containers of the pain, they can become the ones who actually facilitate a healing environment that helps people to deal with the pandemic.
Elna Schütz: South Africa’s daily new Covid-19 cases have steadily dropped since the peak around August, and there’s no strong indication currently of a second wave. Life is returning to a kind of normal with the lockdown currently in its lowest stage, although escalation in the future is possible.
But the effect on society may be long lasting. Collective trauma can’t just be dragged into a hospital room and treated. Researchers like Mogapi hope that by understanding the trauma more, and by working with the collective as best they can, an entire society could find healing.
Nomfundo Mogapi: You know, I’ve been working with trauma for the past 20 years. And I work in an organization that specializes in working with trauma. And I have just been amazed at the capacity of the human psyche and the human soul, so to say, to just heal.
For all of Undark’s coverage of the global Covid-19 pandemic, please visit our extensive coronavirus archive.
Lydia Chain: Elna, thanks for joining us on the show.
Elna Schütz: Hi Lydia, thank you.
Lydia Chain: In addition to what the psychologists in this story talk about, is there anything else that needs to happen to redress this trauma?
Elna Schütz: So while this story and this issue is undoubtably psychological and affects a society primarily on that level, of course real life practical issues have an effect on it. So if you know that there is a collective trauma that has come out of a particular situation such as a pandemic or perhaps some kind of political issues, you can’t just say to a society that it must heal with nothing changing in real life. One must still understand that the more that one does either as an individual or as leadership or even government to heal those original fault lines, all those things that have contributed to a trauma, the more it will also psychologically lend itself to a healthier society. So, in the case of Covid, this could be the kind of thing where we’re talking about inequalities in terms of health care or where people have maybe been left with long-term economic consequences of the pandemic and its lockdowns. Of course, while a society is trying to heal if those inequalities are still present its going to be harder to do that.
Lydia Chain: Mogapi mentions the role of leadership at the end of the piece. Can you elaborate a bit on that?
Elna Schütz: So Mogapi speaks a lot about wounded leadership and the role that the individual psychology of leaders, whether they are in governmental or even just social positions, how that individual psychology affects their ability to lead and ultimately the society because they are having an effect on schools, governments, social groupings as a whole. So the main idea there is if these spaces and these people in positions of power, in positions of leadership, can be brought to a healthy psychological space and supported in those spaces, that hopefully there will be a more positive effect on the society as a whole and on the unraveling of these psychological issues like a collective trauma. It’s the idea that when you take care of a leader, that has a trickle-down effect or quite a wide-reaching effect on anything their leadership touches.
Lydia Chain: Elna Schütz is a news, health, and culture journalist in South Africa. Our theme music is by the Undark team, and additional music in today’s episode is from Kevin MacLeod at Incompetech. I’m your host, Lydia Chain. See you next month.