It is a strange time to be anything right now, including being a therapist.
Many of us have had to transition to working online or on the telephone pretty much overnight, some moving practices from rented therapy rooms to our front rooms (or even bedrooms, for those sharing a small flat with others) and we are faced with the unusual situation of being in the same national crisis situation as our clients, even though our experience of it might be very different (same storm, different boats).
Image: Wired to the Moon by Lucy Campbell
One thing that has struck me is the variety of how we, as individuals and as cultures, have responded respond to this situation. For example, some of us prefer to be positive and not to think about the difficult events going on in the world. Maybe this strategy has served us well in life, avoiding pain and “being strong” or avoiding exposure to triggers that might cause our anxiety or sadness or other difficult feelings to increase. I have particularly noticed this when I hear reports from cabinet members of the Prime Minister being in “Good spirits” – even when he had just been released from intensive care.
Whilst as a therapist I agree that for some people removing triggering stimuli can definitely be a form of self care, I wonder if this culture of “It isn’t okay not to be okay” or “be strong” is something that is so prevalent in the current Government because of their backgrounds of attending elite boarding schools within the stiff upper lip, upper class English culture? Are we trying to avoid painful feelings, but really just repressing them, which in the end can be more painful?
I read press reports of how, before he became ill, Boris had viewed illness as a weakness. These are the sorts of beliefs that often lead people into the incongruent states that result in them showing up in the therapy room. If we are unable to accept our bodies and ourselves for what they are, we often become adept at serially overriding our own needs. Our culture often demands this of people. Go to work when you aren’t feeling well. Push on through. Keep up the pace. Go the extra mile. You're not that poorly. You won't catch it. That's not a “corona cough”. Man up. Take one for the team. Put in the hours. Go beyond the call of duty. But, often, ignoring our own needs can result in us becoming depressed, anxious, burnt out or numb.
Brené Brown has popularised the idea that leaning into your vulnerability, rather than denying it is actually the healthier and more courageous place to be. If I’d heard that Boris was actually really scared, exhausted and relieved having been in intensive care, and having survived, I would feel more of a genuine connection to him. Admitting and accepting our own needs can feel weak, child-like and selfish, but actually leads to greater connection with yourself and others, and a greater ability to meet your own needs and those of others. Vulnerability breeds intimacy, providing that we aren’t rubbing up against someone else who hasn’t worked through their own injunctions (messages internalised from parent figures / society) about vulnerability meaning weakness.
Other ways of dealing with the crisis, particularly in the earlier days, have included people immersing themselves in a lot of information, feeling that knowledge is power. Wanting a sense of being able to regain some control by knowing as much as you can. Whilst this might fuel anxiety for some, it might help others feel more balanced (I watched this interesting YouTube piece about how this is particularly true for those with autism - https://m.youtube.com/watch?feature=youtu.be&v=d1zslJFDM2M) As the time has progressed, I’m guessing we are all learning what works best for us. What helps us regulate our own emotions and feel as okay as we can do, considering where we all are. Perhaps the space, for those privileged enough to have space, has even given some of us the chance to listen to ourselves more, like the empty city streets have enabled us to hear the singing of the birds.
For many, this time may be restimulating old traumas, and difficult ways of being in the world, for example those who have had or do have OCD relating to contamination. Being told to wash your hands or to wash food packaging or not to touch a delivery parcel for three days can be difficult to those who have worked hard to overcome rituals (compulsions) such as handwashing, or thoughts (obsessions) where a person continually doubts if they are really safe or not (which is why OCD is sometimes called the doubting disease). The bubble of their home may feel safe now, but what about when the lockdown ends? Can they trust others to keep them safe outside of the space that they can control? There may be links back to historical feelings of violation and lack of safety, but the fear can still feel very real.
There is a split between those who want to criticise the Government and those who don’t think it is the time to be doing such things. Again does this divide link to how have we historically felt safe? Whose role was it to keep us safe as children? What messages do we learn about criticising our caregivers / authority figures as children? Did we have to do some of this protection work ourselves (become little parents?) How much are we playing out these historical roles in the current situation? Is trust (in authority) something that is built through scrutiny or harmony in our families?
For some who have been housebound through social anxiety or other conditions before this crisis, this may be a time where they are reconnecting with friends and being included more than ever, through video calls, film watching sessions etc., that don’t require them to leave their safe space of their house. But for others, their usual lifelines have been removed. They can no longer get home food delivery slots. The medical or care staff who usually support them with a chronic condition may have been redeployed elsewhere. They may be left to care for themselves, even when unwell with COVID 19, because of lack of PPE, or the fear of further infection in hospitals, not being able to get through to 111 or DWP.
Our contexts are also very different, how our hand has been dealt in this time - those who have been fine, unwell, very unwell or have lost someone; living alone, with family, or sharing with housemates; in a big house with a garden, or an overcrowded council flat in a tower block or somewhere in between; in the city or in the countryside; able to control our safety and exposure to risk of infection or not (because of differing practices of those in the household); working on the front line, working with the public, working from home or not working; qualifying for Furlough, state support and grants or losing all income; having kids in the house to educate or missing cuddles with kids they can’t be with; being trapped at home with an abuser; being apart from loved ones; losing loved ones; being worried about friends and family who are unwell; enjoying the space or time with family; missing the things we cannot do; receiving regular supermarket deliveries, being okay to go shopping, or fearing or being unable to go to the shops and struggling to get deliveries; loving the space, having less decisions to make, less stressful running about everywhere and demands on our time, or hating the claustrophobia, lack of routine and lack of contact with others.
There is also something about where you were (physically and in your lives) when the pause button got pressed. Are you living with a husband you are divorcing? Have you just broken up with a long-term partner and are now living in a studio flat on your own? Have you just started to go freelance and all your contracts have dried up? Have you just put all your savings into opening a restaurant? Were you just about to start working abroad? Have you just started working in a hospital? Has a family member just died and you are alone and have no one to physically comfort you in your grief?
Some are finding it harder to be with our feelings during this time, as a result of being in a fairly constant “stress” state, but others have found that in lockdown they have to be with and listen to the difficult feelings that they might usually seek to avoid through being busy, and that ultimately being a healthy thing. Getting to know yourself more. What do you need, when life is more about meeting basic needs (food, rest, exercise)? Is there more space to listen to ourselves at this time? Can we tune into ourselves, if there are less competing demands for our time? Or are there more demands, with children to teach and working from home, no space for ourselves?
Have you gone through a grief cycle of trying to control, bargain, feel anger, feel sadness, but then realise that acceptance and succumbing to the situation may be one of the only ways of being in a world that is so out of our control, in ways we could never had thought imaginable? Sitting with lack of control is part of the process of succumbing, knowing that we may not even be able to control the things we seek to control the most – the loss of those we love.
Having the lockdown also provides us with a kind of frame or boundary that we are not used to having in our lives. Some spoke of the relief when it was imposed, like the responsibility was taken off our own shoulders and taken by the Government – the ultimate authority figure, for some, mirroring relief that children feel when parents set boundaries that take care of them. But I will be interested to see how we emerge from this.. will we feel safe coming out of the other side? What will need to be in place for us to feel safe? Do we need everyone to be wearing face masks to trust they won't breath the virus on us? Will we be feeling safe going back to work, getting back on public transport without a vaccine, when we have spent two months of being told we that could die or kill someone if we lie down in the park or get closer than two meters to them? It seems a long way away from the initial messages of just wash your hands, carry on your lives and you will be fine. How can we self-regulate our emotions, when the foundations of the protection by our Government (parent figure state) have been so rocky and changeable.
Whilst any of us can catch the virus, lose a loved one or suffer economic loss in this storm; what has really been a wake up call, is how lack of privilege, including being BAME, means you are more likely to die from COVID-19. Whilst there have been mental health challenges for many of us, and we may be learning about new ways to resource our own resilience, I hope that one outcome of this difficult time will be the Government funding more counselling services for those who are not fortunate enough to be able to pay for therapy themselves. The trauma of this pandemic will be in, many ways a collective experience, but we must remember we are in very different boats and we need to give even greater support to those whose boats are already less resilient and less likely to weather the storm.
[NB - none of the examples given in this blog refer to actual clients I am working or have worked with, to protect their confidentiality, and the privacy and dignity of their therapy work. I am drawing on my broader theoretical and clinical knowledge to inform my response.]