You are probably already familiar with CDC health guidelines regarding the prevention of Coronavirus already: wash your hands with soap and water for at least twenty seconds; frequently disinfect commonly used surfaces; stay six feet away from others during social distancing; stay home as much as possible; self-isolate if you are sick. Yet during this pandemic, we have yet to discuss the unique challenges that trauma and abuse survivors may face when they are forced to self-isolate more than they already have and encounter barriers in accessing the support systems they had in place in every facet of their life. Nor have we discussed how the pandemic may be worsening the behavior of those who often terrorize others during particularly vulnerable times – as narcissists are prone to doing. Although this is by no means an exhaustive list, here are three ways trauma survivors are being affected, especially if they are survivors of narcissistic individuals, and tips on how to cope.

1. The exacerbation of trauma symptoms and preexisting conditions.

Some trauma survivors may notice an uptick in their symptoms during this time, including increased anxiety, depression, and hypervigilance due to the pervasive and invasive nature of the pandemic. The majority of those with PTSD have at least one other comorbid mental health condition, and those with PTSD tend to have a greater severity and frequency of health problems and medical conditions; this can be due to the long-term activation of biological stress pathways, like their HPA axis over-releasing the stress hormone cortisol, which decreases immune activity (Pacella, Hruska, and Delahanty 2013). People with PTSD may also have a “hyperfocus” on their somatic symptoms and this anxiety can reach catastrophic proportions during a pandemic. Those who are immunocompromised, have chronic illnesses or struggle with physical injuries and disabilities can feel overwhelmed by the additional challenges and fear caused by this health crisis. Some already self-isolate and find themselves feeling even more isolated as a result of the crisis, which can worsen their health problems.

Social support is one of the most important factors in recovery from trauma symptoms, helping with the processing of trauma as well as reducing emotional distress (Carlson, 2016). If you yourself are struggling, know that you might need additional social support during this time – reach out to trusted others and keep them informed about how you are doing; ask your doctor and therapist about possible telehealth options so you can discuss your medical or mental health conditions and how they may be affected and best managed during this time.

Utilize digital options for self-care: listen to guided meditations online (including progressive muscle relaxation meditations if they prove helpful to you), look up grounding techniques and mindfulness tools; watch relaxing content like nature videos, comedy or pet videos; put on soothing music. Maintain daily contact through family members, friends, and neighbors through safe outlets like facetime, e-mail, phone calls, and text messages. Try your best to keep a steady schedule if you can (for example, carve out specific time to do work or relax; keep attending lectures or classes if your university has transitioned to online classes; make your work-from-home circumstances even more comfortable during this time). If you have a comorbid condition like substance use disorder which could be worsened during this time due to self-isolation, try not to purchase alcohol during this time; not only will it weaken your immune system further, it can cause a flare-up in anxiety or negative thinking.

A note about social distancing:Since seemingly healthy people can still carry the virus and pass it onto those who are more physically vulnerable, it can cause further anxiety and self-isolation to prevent getting it from “carriers.” That’s why it’s so important more than ever during this time (including those who are not as vulnerable or immunocompromised) to avoid large social gatherings, not travel, cancel social events and stay at home as much as possible. You may feel healthy, but know that those who are elderly or struggling with preexisting conditions are not – and you could easily spread the virus to them unknowingly if you have it, which could be lethal to them. If you are lucky enough not to struggle with preexisting conditions, do reach out to those who are extra vulnerable during this time through safe outlets like phone, e-mail, and text message.

2. Some trauma survivors will feel eerily “calm.”

In contrast to this enhanced sense of alarm, some trauma survivors might find themselves feeling calm during this period and wonder why. It might be because the storm you feel like your mind and body have been preparing for has arrived in a sense of a tangible danger and you feel a bit more emotionally prepared for it. In a few cases, you could be experiencing a high level of emotional numbing and dissociation due to emotional overwhelm (feeling separate from your body or the world), especially if you have suffered from cases of complex trauma, where dissociation is more common (Herman, 2015).

As trauma survivors, we are constantly on alert for the danger to come. Weve been preparing for it our whole lives. So while trauma survivors are obviously horrified by this pandemic, are exercising great caution and struggling with grief given the devastating losses around the world, now that there is a tangible danger that has arrived that we know the ins and outs of, our survival skills are kicking in and we may feel more prepared than most emotionally wise. In addition, now other people are feeling in a similar way as trauma survivors do on a daily basis – they too may be enduring hypervigilance, anxiety or depression. This cuts through the alienation that survivors often feel and offers some validation for a reality they live in every day, though they wouldnt wish this experience on anyone. There is now a sense of, “We are all in this together.”

That said, it shouldnt take a global pandemic or collective trauma for people to develop empathy for others or see their perspective. If you are not a trauma survivor, be mindful that what you are experiencing now is something others have experienced for years; let this experience benefit and shape how you approach yourself (with self-compassion) and others with trauma symptoms in the future – with more kindness, empathy, and understanding. If you are a trauma survivor who is feeling more “calm” during this time, now is an ideal time for safe modes of outreach, community building, leadership and making use of your resourcefulness – find small ways you can lead by example and use this as an opportunity to give back while still protecting yourself.

3. Survivors of narcissists are likely to be contacted by the narcissists in their lives at a rapid rate and predatory individuals are now increasing their abusive behavior.

During this time, it’s important to keep in mind that self-isolation isn’t just affecting trauma survivors, but also the perpetrators who caused these traumas in the first place. Remember that narcissistic individuals often crave high amounts of attention, while psychopathic individuals are prone to boredom and need constant stimulation (Hare, 2011). This makes for a crazymaking cocktail if you are dealing with an individual who has either of these traits and acts on them aggressively to harm others. Yes, even during a global health crisis, narcissists will want the focus to be on them during this time, while psychopaths will purposely and even sadistically manufacture chaos and inflict pain in order to derive pleasure. These toxic individuals swoop in when their victims are most vulnerable, and a pandemic is no exception.

Forced isolation may be causing narcissists and psychopaths to focus intensely on their victims since they are no longer able to gain sources of narcissistic supply outside of the home; this can cause even more episodes of abuse as well as distress to survivors who are unable to leave their home. If you are cohabiting with a narcissist in any capacity, do reach out to the National Domestic Violence Hotline to discuss your particular situation and to create a safety plan. RAINN (Rape, Abuse & Incest National Network) suggests that those who are living in close quarters with an abuser make a list of supportive people to have regular check-ins with, take breaks outside if able (walks in more isolated areas still count as social distancing), keep an emergency bag of items like important documents, medications, or keys in case you need to escape, and create a “code word” with your support system to communicate in a time of emergency should you require their help.

Abuse survivors should also be aware of higher levels of what is known as “hoovering” during this time, where toxic former partners, family members, or ex-friends reach out in an attempt to entangle you back in the abuse cycle in order to further control and demean you (Staik, 2020). You may be subjected to love bombing messages which reminisce about the state of your former relationship, pity ploys to try to get you to engage with them, or “just checking in” messages that exploit the pandemic to take advantage of you or your resources. If you are being hoovered, it’s important to “reality-check” the status of the relationship and the character of the person. Keep a list of abusive incidents to ground yourself in the reality of who this person is, rather than who you wish they were. Remember: they don’t miss you. They miss controlling you and are likely seeking whatever supply you can give them (whether it be actual supplies in the form of food, money, or shelter or more intangible supply like praise and attention) even while causing you pain.

Psychopaths, as per usual, are also abusing online services and increasing the frequency of cyberstalking and trolling during this time; since they can no longer abuse others as much in-person, they are shifting to online targets across social media pages, forums, and even dating apps; research has shown that they take sadistic pleasure in this type of internet bullying and provoking others online (Buckels, Trapnell, and Paulhus, 2014). As we increasingly take our interactions to digital platforms, you may notice more trolling and cyberbullying behavior during this time, as well as an increase in digital sadism. It’s important that you document (and if needed, report) all instances of harassment, stalking, or threatening behavior. Just because we have a health crisis does not mean we should have a shortage of accountability.

Make sure you have preemptively blocked all those who have a toxic influence on your life from contacting you through social media, by phone or e-mail. Resist the urge to respond to hoovering attempts. While practicing social connection remains as paramount as ever during this time, make sure it’s the right type of connection: one that will nourish you and your well-being like medicine, rather than escalate your stress like poison.