The [Covid] diary of a psychotherapist

Before lockdown, clients needed to make an effort to see their therapists but now they stay in bed. Lulu Sinclair discusses the trials and tribulations of being a psychotherapist during a pandemic.

I was seeing clients face-to-face until March 23 this year when I, like everyone else, was forced into lockdown by Covid-19…

The change was dramatic. I went from sitting opposite a client, observing them, noting how they talked – or didn’t – watching how they moved – or didn’t – to nothing, just a disembodied voice on the end of a telephone line.

I am a journalist turned counsellor/psychotherapist and my work, rather like my journalism, is all in the detail. It’s intense, intimate and requires real concentration if I’m to give my best. This was important before lockdown but now, as more people begin to suffer the effects of isolation and separateness from others, it’s become vital.

An article in July’s Lancet suggests lockdown is causing mental health issues for people who were previously mentally healthy while people with pre-existing mental health problems are getting worse.

The article cites increased stress, anger and, for some, an inclination to indulge in increased risky behaviour such as online gambling and drinking. It talks about young people particularly and warns of the effect the separation from others may have on them.

My own clients’ issues range from bereavement, loneliness, loss to addiction, domestic abuse and anxiety and/or depression. Imagine what lockdown has done to them? Those who already felt isolated felt so much worse. They had no focus, no routine, no nothing. And no-one to offer support or comfort. Imagine, if you have depression, how hard it is to make yourself do something at the best of times. When there is no need to, the battle is lost.

Before lockdown, clients literally needed to make an effort to come to see me. They had to dress, travel to our meeting room and be prepared to put in the effort for us to work together to try and find a way of gaining some satisfaction in life. It’s a hard ask at the best of times.

During lockdown, very little effort was needed and several of my clients told me they were still in bed. That made a difficult process harder still. I worked round it using Zoom when possible and that helped to a certain extent. I learned to gauge how they were feeling by how they looked. It was trickier with male clients because a number of males (not necessarily those in therapy) took the decision to stop shaving so it was sometimes hard to see if “unkempt” was because of sadness or a desire to be on trend. The latter would be positive, but the former something to keep an eye on. My female clients were easier to read. Made up equalled effort so possibly a better day; no make-up and that was food for thought. Mine at any rate.

Strangely, I got more out of telephone counselling with a client than I had thought possible. I learned to interpret the pauses, pick up unusual sounds – one client was tapping furiously with her fingernails and completely unaware of it until I brought it to her attention – and work with the sounds available. It’s surprising how much emotion you can pick up from a voice.

And now we hear we may be locked down once again.

I have been “seeing” someone who was looking forward to university and the change that was going to bring. Imagine now how that person feels not knowing if, when they arrive at university, they’re going to be barricaded in? Believe me, they are concerned. They were moving forward in their own life, easing themselves out of a sad and precarious place and now, instead of facing a whole world out there and whatever the new experience brings, they are facing life behind bars.

So, we have uncertainty to add to fear of the virus. Human beings do not like uncertainty and very often will make wrong calls to avoid the feeling. Each and every one of my clients has expressed anger at what they see as our leadership unable to make a decision. I suppose our leaders have the same problem and are presently terrified of making the wrong one hence the move towards entombing us behind closed doors once again.

And if we, who have some understanding of what is going on around us, are becoming increasingly unsettled, imagine what it is like for the very young to whom one can’t explain but who feel something is wrong. I watch toddlers move hastily out of the way as I walk towards them. That is really unhealthy and, I believe, it may linger as a bodily memory long after this traumatic time has ended.

The same can be said for those with dementia and, sadly, only their relatives seem concerned about them. A friend’s mother is in a care home and she is not too aware but she does know her children and, this friend says, she looks puzzled when she sees them smiling and waving at her but separated by glass. They can’t touch and we all know how important touch is.

You could suggest that it might be comforting to those with mental health problems to know we are all experiencing what they usually feel but somehow that doesn’t help. Unfortunately, one’s own pain is not lessened by knowing someone else is feeling a similar one. I want to reassure my clients that it will all be fine soon but can’t because none of us have any idea how this pandemic is going to pan out. All I can do is try and hold them in their unhappiness, while trying to keep mine at bay. A hard job is getting harder.

Personally, I feel I have had enough. I want to stop living in fear. I am prepared to follow the guidelines but I want to have the chance to start living again as a fully-formed adult. That means making my own decisions, not waiting for someone else to give me permission to do so, particularly when I suspect they have no more clue than I have.

Photo credit: Deposit photos

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Lulu Sinclair

Lulu is an experienced journalist who has worked in print, TV, radio and digital media. She retrained as a psychotherapist and counsellor some years ago and now combines both her passions. She writes a regular blog on mental health topics for a Harley Street psychotherapy practice.

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