Temenos Roundtable: Psychotherapy During a Pandemic

Contributors: Dana Bannon, LPC; Pat Duffy, MSS, LCSW;
Terry Hall, MA, LPC; Antoinette Tate, PhD

Recently, the clinicians at the Temenos Center were asked to share their experiences with and observations of the COVID-19 pandemic from their perspectives as therapists, to be shared during a Town Hall with a health advocacy group. We decided to put our thoughts together here, to share with our Temenos community as well.

At The Beginning

Initially people shared their sense of vulnerability, fear, and the uncertainty of how to keep safe. As therapists, we were going through the same anxiety and fear as our clients, which created both a sense of connection and shared vulnerability. Something I don’t remember experiencing since 9/11. – Terry

New Ways of Connecting

Initially during the pandemic many of my clients were hesitant about using tele-health as a replacement for therapy. Most people have adjusted to the zoom sessions and we have a different entry in people’s lives. We meet their pets, get a bird’s eye view of their living spaces, and occasionally meet a family member, encounter a laugh or a spat, and share a laugh about something that never would have entered the therapy space before. One of my clients likes to hike and so occasionally, we “hike” together and send pictures back and forth about what we see. We are both careful about privacy and I would never have considered such a thing before. – Terry

Unique Challenges

I noticed the teens that I work with seemed to handle quarantining with stride until the winter months. Once January hit, I started seeing a noticeable increase in substance use, whether it’s vaping nicotine or using harder substances. This seemed primarily due to boredom. – Dana

As Terry referenced, I do think about the unique challenge we face as clinicians, living through this pandemic with our patients. In recent months it has felt to me that COVID fatigue set in for many of my patients. As winter wound down and we crossed the one year anniversary, and even with the vaccine, it seems to me that people are feeling weary. Or maybe it’s just me? – Pat

The pandemic and restrictions really changed what clients had available in terms of their coping  skills. Clients didn’t have access to the same resources, like clubs, art classes, exercise classes, volunteering and more. They could not safely visit with family and friends. A couple of retired clients talked about losing their sense of purpose and struggling to re-define this. I noticed a surge in suicidal thoughts in late Spring of 2020 as it became clear that the changes to the world were persisting, and again during the winter months when access to newly identified resources was again limited. Clients talked about losing time from life, whether that was a newly graduated college student or someone in retirement. – Antoinette

As the pandemic wore on and approached one year, my clients expressed interminable boredom, like one day passes into the next with little to punctuate one day from another. I feel like my role as therapist is to enter the boredom with them and help people find some creative options for stimulation and connection. – Terry

Growth Continues

We are now talking about what people are learning from the quarantine, what they would like to keep and what they are looking forward to getting back to. A few of my clients have lost loved ones as a result of the virus, and are grieving, looking for ways to honor the dead that they could not at the time. We are all trying to figure out vaccines, the “new normal”, what is safe, and what continues to be a risk. Those that have fared best made sure they stayed connected to family and friends, kept connected to interests or hobbies in some ways, and flexibly adapted to the ever-changing information and mandates. Some of our best sessions arose from “not having anything to talk about”, which invited conversations about deeper thoughts and feelings. – Terry

Many teens and adults found the time to work on themselves and practice new coping skills. It has proven to be an exploratory period for all of my clients, which has certainly had its benefits. – Dana

Looking Forward

I hear more and more clients tell me they have gotten vaccinated and there seems to be growing hope. There is also anxiety as any time of transition is more challenging than the status quo. From what I am hearing, it’s not that anyone wants this way of life to continue longer than needed; but we’re again entering a time of transition and uncertainty. Routines need to be revised and re-established, and boundaries need to be re-negotiated. – Antoinette

Some of my clients are worried that they have forgotten to move about the world comfortably again. Driving, social interactions and coming out again is anxiety provoking, especially for those who tend to hibernate and isolate. However, just about everyone I know is looking forward to the freedom and the outdoors as they consider life after the pandemic. – Terry

My hope is that we are on the brink of brighter days. I think that I am beginning to see that hope opening up in my patients. I think about how we all have been just trying to get to the other side of this pandemic. I wonder if we are allowing ourselves to feel more (both hope and fatigue) as we see some light at the end of the tunnel. Or, is it mostly in me? – Pat