Therapy in the Time of Coronavirus

With anxiety skyrocketing in the face of immense global uncertainty, therapy, like hand washing, seems advisable for everyone, therapists included.

Coronavirus is, among many other monikers, a leveler. For the first time since becoming a therapist, I’ve had client after client ask me at the start of our sessions, “How are you? How are you in all of this?” The tables turned from the question I consistently ask of them.

I don’t give the full answer, because I reserve that for my hour with my therapist, but the full answer is somewhere close to this: Trying to pin down how I am is like trying to arrest a pin wheel in a tornado. The emotions come on fast and can change in an instant. This has always been true, but it’s occurring at a higher volume now. Some moments I am okay, some moments I am in the spiral of death anxiety. Some moments I am grieving the plans that will not be lived out—visions that won’t come to fruition. Some moments I am fuming at my partner for existing in the same small square footage as me and some moments I am immensely grateful and overcome with love for that same partner. Some moments, I wish I was the dog—pleased with the turn of events. Some moments I am laughing and truly happy. And on and on the wheel spins.

Boundaries are what make therapy work. Confidentiality—the assurance that your therapist will not disclose what you have shared in session—is the bedrock to therapy. Confidentiality is fundamental. But the boundary of how much you as a therapist share of yourself with your client is hazier.

Some schools of thought espouse that the therapist should be the tabula rasa—the blank slate onto which the client can project his/her/their own ideas, needs, beliefs. Other’s believe that there can be utility in thoughtful self-disclosure on the part of the therapist.

You train formally for several years to become a therapist, but in the end the summation of all the training is this: technique will only take you so far—the thing that matters most for therapy being effective is the quality of your relationship with the client. Or said more elegantly by Khalil Gibran: “Work is love made visible.”

I have wrestled often with the question of self-disclosure as I’ve walked down the path of becoming a therapist. One of the therapists I admire most in the world, Tara Brach, a Buddhist psychologist and writer, models self-disclosure as a tool for healing. While I don’t know how much self-disclosure happens in her individual sessions (I’d wager not too much), she has written books where she explores with specificity her own path through depression and grief and anxiety. And this writing has been immensely healing and helpful for so many people—certainly for me, perhaps for her clients too.

The reality of therapy in the time of coronavirus is this: it’s impossible to be a true tabula rasa for a client right now. Everyone knows that everyone (their therapist included) is impacted in some way by the pandemic. And furthermore, therapists are largely conducting sessions by video from their homes. There are dogs barking and cats parading around and babies crying in the background rumble, behind the closed door, or there is quiet—all of which communicates something about the home, and there is the physical space of the home that shows up on the screen. Personal life, especially if you live in close quarters, is revealed.

And is this so bad?

Honestly, I don’t know. None of us do. This is the experiment we are all taking part in, and the results are not in.

The description of healing connection that has always made the most sense to me, is as follows:

“Compassion is not a relationship between the healer and the wounded. It’s a relationship between equals. Only when we know our own darkness well, can we be present with the darkness of others. Compassion becomes real when we recognize our shared humanity.

— Pema Chödrön

My blog exists in the public domain of the internet. It is a window into who I am as human. It is a window into how I’ve explored my own darkness. And if a client of mine reads this blog, it might be a burden or a gift or both.

On this website, I have encouraged other’s to share their story. In my urging I state: “Shared stories create common bonds that help us to see that we are not alone in our inner sanctums of crazy or divine.” Stories, I’m convinced, are our connective tissue as a species.

We are all living the shared story of coronavirus simultaneously. It is a moment of global human connection that has not existed before in most of our lifetimes. And, how we live out this experience is particular and singular for each of us too.

I don’t go into detail in my sessions with clients when they ask how I am. Because the session time is theirs and it is precious to have a segment of time where you get to explore your particular and singular experience. But there is something that is present in that exchange of “how are you?” A moment where we are two humans acknowledging to each other from screens across town: we are all in this together.

And this is not just true now; this has always been true. No human escapes suffering over the course of a lifetime, irregardless of pandemics. And again, the wise words of the Buddhist nun Pema Chodron rise to the surface: “Compassion is not a relationship between the healer and the wounded. It’s a relationship between equals.”

And maybe, this moment in time, will shine a light on that truth that will continue unfolding as time stretches onward.