As a psychotherapist, my work is all about connection. It’s about supporting my clients by cultivating an understanding of who they are and where they’ve been.
But therapists are people, too, and we have our own issues. We fight with our partners, apologize to our kids for bad parenting moments, get sick, lose loved ones, the list goes on. We often have to put our stuff aside in order to focus on the client’s reality, and our ability to do that is a skill honed with years of practice. It eventually becomes a fairly effortless part of the work.
My work feels different since the onset of this global pandemic. Putting my own stuff aside is far from effortless, it’s sometimes impossible. It feels like I should join in my client’s pain and fear — not maintain the objectivity required to offer an alternate perspective. It would be pathetically inauthentic and patronizing to behave otherwise. We are all sitting in the muck trying to figure out what this all means and how to survive it.
Now, and awkwardly at first, through a screen and a microphone, clients talk to me about their anxiety, their intense fear of the grocery store, their obsessive thoughts about their loved ones dying alone. They talk to me about not knowing what day it is, about not being able to sleep. They wonder if they’re doing enough for their elderly parent who lives alone, or for their three children who resist doing school work. They talk to me about their sadness over the loss of their jobs, their hard-earned nest egg, about moodiness, the need to get space from their partners, feeling paranoid every time they cough or get a chill.
My work feels different since the onset of this global pandemic. Putting my own stuff aside is far from effortless, it’s sometimes impossible.
I listened attentively but found myself struggling with how to respond. It wouldn’t be appropriate to get activated with fear or outrage, or to provide false hope. I kept listening. But I could feel the anxiety, anger and sadness inside myself. I took it in, held a space for it, observed it, validated it.
And I felt completely immobilized, totally stuck.
In March, before I closed my clinical offices, I started writing new protocols for client interactions; I measured the space between chairs in the offices and waiting rooms; I hung up reassuring notices for clients about how serious we were about disinfecting doorknobs, pens and banisters. I ran from store to store searching for hand sanitizer, antibacterial wipes and disinfectant spray. I was taking action. I was telling myself I got this, it’s OK.
But when I couldn’t find any supplies, I felt anxious, fearful and agitated. After a week or two of trying to out-smart and control the coronavirus’ wrath, I burst into tears and felt depressed.
That’s when I realized what was really at play: this is trauma. And I am traumatized. There is a threatening presence wreaking havoc on our lives and we are all in survival mode — including me.
In 1988, early in my career, I was part of a sexual abuse treatment team. A man named Bessel Van der Kolk held a few brown bag lunch trainings in the basement of the center where I worked. He’s since become one of the leading experts on the subject of trauma.
One of Dr. Van der Kolk’s contributions to the field is that he named the preconditions for trauma. When I shifted my identification from trauma therapist to traumatized therapist, I started thinking about these preconditions and realized, they have all been met with this crisis:
a loss of safety; a lack of predictability; a sense of immobility, of being stuck; a loss of connection; a loss of our sense of time and sequence; a loss of meaning, purpose.
When these preconditions are met, our bodies produce stress hormones (adrenaline and cortisol) that trigger the “fight or flight response.” Basically, trauma is an experience of the body. When I started talking to my clients about these preconditions and about the hormones triggering the fight or flight response, it resonated with them. It provided a framework for understanding the thoughts, feelings and behaviors so many of us are experiencing during this pandemic.
It also allowed me to get back into my own body and breathe, remain fully present for my clients and at the same time allow my own struggle. It was OK to join them and sit in the discomfort of uncertainty and the reality that we really don’t have control, even though most of us operate as if we do.
Stress hormones really do create more energy, and that energy is either propelling us to fight or flight. Some people are taking that energy to use their bodies to renovate basements, clean closets, exercise excessively (this is their “fight”).
Others are numbing themselves or hiding away by eating comfort food, drinking or binge-watching TV (this is their “flight”).
Stress hormones really do create more energy, and that energy is either propelling us to fight or flight.
I find myself doing both. I slip into the world of "Outlander" or "Grace and Frankie" and then I find myself full of energy with an ability to push through sizeable endeavors. There is a valid reason for these extremes, and it is the effect of the trauma on our bodies.
The best way to manage this is to keep our minds and our bodies in sync. We have to pay attention to our feelings and intentionally “cool our brains,” as Dr. Van der Kolk would say.
We have to hone our ability to call up the calming response, which for many does not come naturally. A daily practice of yoga, meditation or walking in nature is helpful, if not essential.
It is taking meaningful and deliberate action when faced with a threat that we cannot control.
Finally, it will create the space for us to tell ourselves we got this, it will be OK.