Journal Identification = NRP Article Identification = 0624 Date: June 16, 2021 Time: 3:24 pm
doi:10.1684/nrp.2021.0624
REVUE DE NEUROPSYCHOLOGIE
NEUROSCIENCES COGNITIVES ET CLINIQUES
16
Point of view
Rev Neuropsychol
2020 ; 12 (S1) : 16-8
Post-traumatic stress disorder
and COVID-19 *
Trouble de stress post-traumatique
& Covid-19
Jean-Gabriel Ganascia Professor Sorbonne University Chairman of the CNRS Ethics Committee (COMETS)
ACASA team, LIP6, B.C. 169, 4 pl. Jussieu, 75252, Paris Cedex 05, France
<Jean-Gabriel.Ganascia@lip6.fr>
To cite this article: Ganascia JG. Post- traumatic stress disorder and COVID-19.
Rev Neuropsychol 2020;12(S1):16-8 doi:10.1684/nrp.2021.0624
PTSD
Post-traumatic stress disorder(PTSD in English, or TSPT in French,trouble de stress post-traumatique) affects indi- viduals who have experienced situations endangering their integrity, such as soldiers returning from war zones, former prisoners or deportees, victims of rape, assault or abuse, wit- nesses of attacks, murders or crimes, etc. This is manifested by unexpected attacks of anxiety, difficulty in focusing atten- tion, sleep disturbances, altered emotions and, above all, the sudden and recurring appearance of images associated with the events of the time the trauma originated. Symptoms are grouped into three categories:
1)intrusionof memories related to the source of the trauma;
2) avoidanceof situations reminiscent of the origin of the disorder, which dulls emotions and sensitivity. This results in an emotional, behavioural, and even physiological with- drawal from anything that is likely to come near to or far from the source of the trauma;
3) hyper-stimulationwhich leads to insomnia, great mental pain and difficulty in maintaining attention and carrying out activities to completion.
SPTSD
We present here, heuristically and speculatively, and without claiming any scientific validity, the idea wherein the personal pathology of post-traumatic stress disorder extends in some way to human groups, for example to countries that have suffered major collective trauma, such as wars, inva- sions, epidemics, etc. We will call this collective pathology social post-traumatic stress disorder (SPTSD). Major man- ifestations are similar to those of PTSD, except that they
∗This article is an English language translation of the following article: Ganascia JG. Trouble de stress post-traumatique & Covid-19.
Rev Neuropsychol2020; 12 (2): 132-4. doi:10.1684/nrp.2020.0548.
Correspondence:
J.-G. Ganascia
affect the behaviour of entire populations, especially in their political choices. As a result, they take specific modali- ties. However, and even if their expression differs, the main categories of symptoms of PTSD, intrusion, avoidance and hyper-stimulation, are found in SPTSD.
Intrusion and the “last war” syndrome
The memory of events at the source of the trauma emerges at all times in cultural and political life: commem- orations abound and political speeches and artistic works – films, novels, etc. – constantly refer to these events. Con- sider, in France, the memory of the Second World War: it still bursts into our collective life. This presents an analogy to the symptoms of PTSD characterising intrusion. As a side effect of this untimely and systematic eruption of old mem- ories in the face of adversity, we fail to look at the present as it is, to the point of only preparing for “the last war”.
Thus, in the 1930s, France did not perceive the threat to come until it turned its eyes towards the type of trench war- fare that had unfolded twenty years earlier, during the First World War, which led to the construction of this impassable super-trench that the Maginot line claimed to be.
Avoidance
Because of a cumbersome collective memory, awkward problems are sometimes overlooked. France, for example, still refuses to collect so-called ethnic statistics, which men- tion the origin and family trajectory of people, owing to traumas related to the Vichy regime’s registration of Jews during the Second World War and to the status of the indige- nous people during colonisation. However, such statistics would certainly help understand the difficulties of integrat- ing families with an immigrant background and to remedy such difficulties. In a similar vein, Germany finds it very dif- ficult to implement natalist policies, as this is reminiscent of the Nazi regime’s practices.
Journal Identification = NRP Article Identification = 0624 Date: June 16, 2021 Time: 3:24 pm
REVUE DE NEUROPSYCHOLOGIE
NEUROSCIENCES COGNITIVES ET CLINIQUES
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Hyper-sensibility
Finally, certain subjects which, in the public mind, evoke earlier times, provoke overly animated reactions, which, at a societal level, can be seen as the equivalent of hyper- sensitivity at the individual level. Take, for example, the unprecedented level of concern in France raised by the law of October 2017 on internal security and the fight against terrorism. This led many to fear a totalitarian drift, while this had filled a consequent legal void around the deployment of the web and misuse that might result from this.
Covid-19 health crisis
In the course of the Covid-19 health crisis, during which half of humanity has undergone unprecedented confine- ment, both in terms of its scope and duration, unexpected memories of former collective trauma has come in many regards to obscure reality, by making us lose sight of the issues. We diagnose this as a characterised form of SPTSD.
In the case of France, two major events are found at the root of these traumas, the first distant, the Second World War and the German occupation, the other recent, the epidemic due to the H1N1 influenza A virus, in 2009.
Effect of the H1N1 trauma on the Covid-19 crisis
During this flu epidemic, the state was extremely cau- tious, to the point of ordering a large quantity of masks and, above all, a lot of vaccines which proved to be almost useless, the epidemic not having spread as much as fore- seen. The sense of mismanagement left a strong impression and lingered in the collective memory, as a consequence of an expensive and unnecessary precautionary health pol- icy. Added to this was the strategy of bypassing independent general practitioners in the implementation of a public vac- cination campaign, fostering great animosity among those normally responsible for delivering frontline public health services. As a result, general practitioners adopted a position hostile to government health policy, which then spread to the general population. SPTSD can be characterised by this event in the form of avoidance. The masks, seen as obsolete, were burned, without being tested or replaced, so that this excessively expensive policy could rapidly be put behind us. We outsourced the production of masks and reagents to test for the presence of viruses abroad to the Far East. Finally, the government has shown great concern not to repeat the same mistakes, in particular not to ignore general practition- ers, as it had during the H1N1 epidemic, when they were excluded from the vaccination campaign. Haunted by this memory, it therefore involved general practitioners in mon- itoring the population after the end of confinement, at the risk of considerably slowing down the treatment of those
who had been in contact with contagious patients. This is a typical symptom of “the last war” mentioned earlier, which is that one prepares for future events with one eye on what happened in the past, neither being able to look to the future ahead nor anticipate what is very likely to happen.
Post-traumatic effect of World War II on the Covid-19 health crisis
Undoubtedly, the period of the German occupation of France during the Second World War and, above all, the Vichy regime, remain traumas so important for the French, that they still interfere with current affairs, despite the time that has elapsed. It has been over 75 years since the war ended, so there are very few survivors left from that time, and even fewer reliable eye-witnesses, as these survivors were either too young then or too old today. The fact remains that there are still fears of an authoritarian regime being established, on the back of the crisis, on a scale identical to that which occurred during the German occupation. The memory of the Battle of France, which began on May 10, 1940 and at the end of which, after the Netherlands, Lux- embourg, Belgium and France were invaded by German forces, with Marshal Pétain recalled to the government and entrusted with full powers, continues to wreak havoc.
Echoing this period, and the switch to a police state, dis- proportionate concerns are now emerging about digital tracking applications, intended to contain the pandemic.
We must undoubtedly be concerned about the protection of personal data, to avoid their exploitation for commercial purposes or, worse, the establishment of an authoritarian regime depriving us of our liberty. Nevertheless, there are technical possibilities for anonymous contact tracing which, while helping to limit the effects of the health crisis, respect privacy. We see here both an avoidance of the health issues resulting from the easing of restrictions, which while requir- ing us all to take action, seem to be being ignored, and an over-stimulation of the defence of privacy which makes us blind to any other consideration. The blindness result- ing from this hyperstimulation appears to be twofold. On the one hand, we disregard the work of the mathematicians behind the proposed protocols, even though they consid- erably restrict the risks of being hacked, to the point of making this unlikely in reality. Clearly security risks can- not be completely ruled out. Without doubt, they cannot demonstrate their total impossibility, but neither can they demonstrate the impossibility of hackers tampering with our banking communications. On the other hand, we ignore other, much more probable risks. We could point to those linked to the transmission and storage of health data in the French social security system, the electronic health ser- vice card and the primary health insurance fund database.
Consider also personal information recorded without our knowledge by major web operators, whether social net- works or search engines. An example would be the option,
Journal Identification = NRP Article Identification = 0624 Date: June 16, 2021 Time: 3:24 pm
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Point of view
provided by Google on its Android operating system, osten- sibly to protect owners in case they lose their telephone.
Unless deactivated, this feature not only records but stores all the owner’s movements and photographs taken on the device, for years, with no limit of time. . .
Will we be able, both at a national and European level, to overcome fears from the past and look to the future with realism in order to face the health and environmental crises which are bound to occur in the future?
And, once these crises have passed, will we be able to envision a common future for all? This is part of our col- lective capacity for resilience, about which we still don’t know much, even though we already know how to diagnose SPTSD.
Conflict of interest None.
