The 12 Phases Emotional Algorithm:
The Road To, Through, and Back from Trauma
Excerpted from Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99) by Mark Goulston, MD and Diana Hendel, PharmD.
A traumatic event can shatter your sense of safety and security, and create lasting harm. This is especially true for healthcare workers, many of whom are experiencing symptoms of post-traumatic stress disorder (PTSD) after nearly a year of working on the pandemic frontlines.
Dr. Mark Goulston, coauthor along with Diana Hendel, PharmD of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99), has developed an algorithm that follows the path of trauma and guides healthcare employees safely out again.
“The 12 Phases Emotional Algorithm is a framework that describes the processes that typically occur in your psyche when a traumatic event takes place,” says Dr. Goulston. “It applies not only to healthcare providers but to anyone experiencing intense trauma.”
Phases one through ten describe everything that occurs from the time trauma occurs to the time when PTSD develops. Phases eleven and twelve highlight the journey to recovery and how to get past it. The entire algorithm is the basis for Dr. Goulston’s Surgical Empathy technique. (See attached press release.)
1. Trauma: This is an event of vast proportions that shocks, distresses, and overwhelms you, which temporarily cause you to fight, flee, or freeze mentally and physically.
2. Horror: You see or experience horrific things without having the opportunity to fully feel the horror. This includes shock, surprise, and the inability to comprehend what’s happening.
3. Terror: Your primary focus becomes the survival of your body and psyche.
4. Fragile: You may feel like a windshield in a car that has become cracked, yet not broken. You may feel that the next hit will cause you to “shatter” and never come back. (What is shattered is your prior belief system about your safety and security.)
5. Overriding Panic: Being duty bound by your work causes you to clamp down on any feelings to avoid becoming overwhelmed and freezing as you see others hurting and as you feel your own powerlessness.
6. Suppressed Thoughts: You consciously push whatever you’re tempted to think about out of your conscious mind in order to focus.
7. Repressed Feelings: For the sake of survival, your mind pushes the feelings further down into your unconscious and away from your conscious mind.
8. Focus and Function: You focus and carry on. This is what you now do to live up to responsibilities because there is a higher need at the moment to lead, organize, and unify. You can deal with feelings later.
9. Danger Has Passed: When an acute threat has passed, you may internally relax your guard that has protected you from experiencing intolerable feelings. With that internal guard lowered, the unfelt feelings you repressed and pushed away while the trauma was happening can resurface. Your mind may say I’m safe but your body says, You’re lying.
10. PTSD: PTSD shows up in four major ways: Intrusive Thoughts, Avoidance, Negative Thoughts, and Hyperarousal. You may experience nightmares, anger, irritability, anxiety, hypervigilance, and may be easily startled by loud noises or sudden movement. You may withdraw from social activities, become increasingly isolated, and appear depressed.
11. Disabled or Recovered: You either become further impaired by the trauma you experienced or begin a journey to healing.
12. Healed: You fully reexperience the trauma, along with the full spectrum of emotions and feelings the trauma created, and regain the capacity to feel peace and joy at last.
“Though it can be upsetting or overwhelming to read through the twelve phases that lead to, through, and beyond trauma, do not despair,” says Dr. Goulston. “The algorithm is a powerful key to recovery. When you empathetically revisit these phases one at a time and fully confront your feelings and thoughts at each, the process can help you heal.”
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About the Authors:
Mark Goulston, MD, FAPA
Dr. Mark Goulston is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). He is a board-certified psychiatrist, fellow of the American Psychiatric Association, former assistant clinical professor of psychiatry at UCLA NPI, and a former FBI and police hostage negotiation trainer. He is the creator of Theory Y Executive Coaching—which he provides to CEOs, presidents, founders, and entrepreneurs—and is a TEDx and international keynote speaker.
He is the creator and developer of Surgical Empathy, a process to help people recover and heal from PTSD, prevent suicide in teenagers and young adults, and help organizations overcome implicit bias.
Dr. Goulston is the author or principal author of seven prior books, including PTSD for Dummies, Get Out of Your Own Way: Overcoming Self-Defeating Behavior, Just Listen: Discover the Secret to Getting Through to Absolutely Anyone, Real Influence: Persuade Without Pushing and Gain Without Giving In, and Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life. He hosts the My Wakeup Call podcast, where he speaks with influencers about their purpose in life and the wakeup calls that led them there. He also is the co-creator and moderator of the multi-honored documentary Stay Alive: An Intimate Conversation About Suicide Prevention.
He appears frequently as a human psychology and behavior subject-area expert across all media, including news outlets ABC, NBC, CBS, and BBC News, as well as CNN, Today, Oprah, the New York Times, the Wall Street Journal, Forbes, Fortune,Harvard Business Review, Business Insider, Fast Company, Huffington Post, and Westwood One. He was also featured in the PBS special “Just Listen.”
Diana Hendel, PharmD
Dr. Diana Hendel is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). She is an executive coach and leadership consultant, former hospital CEO, and author of Responsible: A Memoir, a riveting and deeply personal account of leading during and through the aftermath of a deadly workplace trauma.
As the CEO of Long Beach Memorial Medical Center and Miller Children’s and Women’s Hospital, Hendel led one of the largest acute care, trauma, and teaching hospital complexes on the West Coast. She has served in leadership roles in numerous community organizations and professional associations, including chair of the California Children’s Hospital Association, executive committee member of the Hospital Association of Southern California, vice chair of the Southern California Leadership Council, chair of the Greater Long Beach Chamber of Commerce, board member of the California Society of Health-System Pharmacists, and leader-in-residence of the Ukleja Center for Ethical Leadership at California State University Long Beach.
She earned a BS in biological sciences from UC Irvine and a Doctor of Pharmacy degree from UC San Francisco. She has spoken about healthcare and leadership at regional and national conferences and at TEDx SoCal on the topic of “Childhood Obesity: Small Steps, Big Change.”
About the Book:
Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99) is available in bookstores nationwide and from major online booksellers.
To learn more, please visit https://whycopewhenyoucanheal.com/.