Therapy in lockdown

[BraveGoldie]

I'm curious about two things.

1. How have people found their therapy experience affected by going online in lockdown?

1. There aren't clear guidelines about when it becomes acceptable to start meeting in person again for therapy, based on the new road map (this is in comparison to the Tier advice which did mention 'support and therapy groups'.... Any ideas/ opinions?

For me, I have found online therapy not nearly as effective - in fact I think it's led to really bad gaps in empathy and communication which have been damaging for me.

I am very keen to get back to being in person (socially distanced of course). But very little about mental well-being is mentioned in any of the new guidelines. Some people must be hugely struggling and video just doesn't cut it. Should MH be viewed as seriously as other medical needs and therefore should be permitted? Perhaps some have viewed it that way already and continued to meet with therapists, as they would with a doctor?

I am lucky enough not to have severe MH issues, but even so have definitely suffered from being cut off from in-person sessions, and don't know when I can go back to them. (I also can't afford to keep paying the same amount for video sessions that I don't find nearly so effective!)

What are other's experiences and opinions?

My Therapist has underlying health conditions, so was asked do I want to continue sessions through zoom.
I am not a big consumer of therapy, so this has been mine first real experience of it. I did find it odd at first and aside from one time when my internet connection went down, have not had any real issues and have gotten used to it.
Biggest problem I had was trying to think of something to talk about in my sessions, as my social contact was so minimal.

Mine was really good, great therapist BUY
the number of sessions was limited to six because of demand (would have been more pre covid). Realised something pretty big in my last session which I need to work on more but no more sessions available and I've felt like I'm slowly drowning ever since.

It was all over the phone - never once laid eyes on the therapist and that was fine by me. Better in many ways as I was able to sit wherever was most comfortable and didn't have to wait about getting there, my appearance etc. I can totally see how that wouldn't work for some people and I can see that it might also be dependent on the dynamic between you and the particular counsellor.

Oh I am so glad it worked for you so well @awesomekaren . Isn't that weird and cool? That someone could have helped you significantly without ever seeing or meeting them? I am sorry things have been tough since..... I hope things get better soon.

The setting I work in has been allowed to continue with face to face sessions in line with covid guidelines. It's been my experience as the counsellor that my clients prefer telephone counselling for the time being.
On a personal note and I'm aware this isn't what you've asked, travelling to work means 2 buses so I'm not comfortable with that just yet, but I am eager to have a full return and see my clients in the normal way as I feel it is important and f2f is much more effective

To clarify, I was given the option to work from home at the start of the lockdown in Jan

@pinkunicorn20 that's really interesting that your work has considered counselling as allowed to continue face to face through lockdown.

It's also really interesting that as a councillor you don't consider phone calls as as effective.

My experience is that silences in person can be hugely significant and healing, as you feel the presence and the 'being with ness' with another person you trust. On phone calls all I feel is silence. .... it's a much lonelier feeling. And one time in particular, my therapist started saying things that felt so out of touch with where I was emotionally that it really damaged the relationship and I felt very exposed and hurt (and now much mire wary of speaking). I think he screwed up, but I also think not being in person was a big factor.

can only agree with you about the silence, therapeutically it can be very effective and being 'with' someone is a massive part of that. I'm sorry you've had that experience and can fully understand why you've had that reaction.

My particular agency specialises in bereavement which is why we have been allowed to remain f2f. I believe its considered an essential service but I'm happy to be corrected.

I do believe for some telephone or online counselling can be effective but that there are many elements to consider, for example I would not begin a new therapeutic relationship with with client I have not met in person first, ideally I would hope to establish that relationship first and utilise telephone or online as a short term measure.

Do you feel able to speak to your counsellor about how you felt during that session?

I’ve been having Zoom EMDR therapy for months throughout the pandemic and have found it absolutely fine. If anything, better - EMDR can be incredibly distressing and draining so it is great to just be able to crawl into bed afterwards if I need to.

I did have something by phone a while back and didn’t find that helpful. But I’ve built a relationship with my therapist over Zoom that feels just the same as in-person therapy I’ve had in the past. It feels a little weird at first but you get used to it.

Thanks @pinkunicorn20 . Totally understand why your service was allowed to remain open - I absolutely do think MH is an essential service, and sadly even more people must be needing support right now.

I have talked to him about it..... but he's a psychoanalyst, which means he does not want to either say sorry or acknowledge that he actually did anything.... he keeps using phrases like "something occurred between us and it's clear you feel..." which feels very frustrating and invalidating for me. I have been with him for four years, been through a huge amount in a very deep way - all kinds of positive and negative transference - but I have never ever felt he screwed up before. And unfortunately, because of his special role, when he screws up it hurts like hell.... I think it would heal and I would 'refind him/ my faith in the relationship' much better in person, but sadly not possible for now......

Thank you for what you are doing to support people through this (and other times!) it must be a very draining (though rewarding) job, and I hope you can take care of yourself too.... (while giving support to randoms like me on the internet! 😅)

@picklespark

I did have something by phone a while back and didn’t find that helpful. But I’ve built a relationship with my therapist over Zoom that feels just the same as in-person therapy I’ve had in the past. It feels a little weird at first but you get used to it.

That's great to hear, Picklespark!

I've found it great. Especially because of where we live. It is much more convenient.

I’ve received clinical supervision via Skype and delivered sessions via Zoom. There are issues particularly with noticing body language, but it’s fine, and as pp have said there are advantages.

@BraveGoldie

Thanks *@pinkunicorn20* . Totally understand why your service was allowed to remain open - I absolutely do think MH is an essential service, and sadly even more people must be needing support right now.

I have talked to him about it..... but he's a psychoanalyst, which means he does not want to either say sorry or acknowledge that he actually did anything.... he keeps using phrases like "something occurred between us and it's clear you feel..." which feels very frustrating and invalidating for me. I have been with him for four years, been through a huge amount in a very deep way - all kinds of positive and negative transference - but I have never ever felt he screwed up before. And unfortunately, because of his special role, when he screws up it hurts like hell.... I think it would heal and I would 'refind him/ my faith in the relationship' much better in person, but sadly not possible for now......

Thank you for what you are doing to support people through this (and other times!) it must be a very draining (though rewarding) job, and I hope you can take care of yourself too.... (while giving support to randoms like me on the internet! 😅)

I think it could be a useful bit of the work you're doing - to really examine your expectations that he be perfectly attuned to you and that if he isn't he has "messed up".

Because after all the goal of therapy/analysis is to become more touch with reality. Perfect attunement and congruence doesn't in fact exist although as patients we can feel it does when we are in more of an idealisation phase.

I don't say this judgmentally but rather with curiosity I guess. Disillusionment and the acceptance of it is part of what happens in therapy isn't it - plus the acceptance of that and the knowledge that something good still does exist and is worth having even if not perfect.

It's an important part of growing up in therapy I think.

Although it's painful (tell me about it!) it does mean you're doing the work. In this sense I think remote therapy can move things along, developmentally.

Yes I do like the 'curl under the duvet' straight after and even 'indulge in a glass of wine' before possibilities! (My session is mid evening, so not totally crazy!) I used to have to drive there...

I started seeing a new therapist in the autumn (after having therapy previously some years back with someone else) and I think the strangest thing is never having met him in person! It lacks the atmosphere of being in the room, for example how every building and every person kind of has their scent and that's missing. It may also sound weird but I think a lot about how he's only ever seen the upper half of my body on a screen and doesn't know things like how tall I am and how I would walk in etc.

On the whole I've found it a good experience though. I think in some ways I've felt braver to share some things quicker too and it's of course nice to be at home at the end of the session. I have a little routine of making a cup of tea and having a biscuit or two after my sessions. In a practical way, very convenient to not have to spend an hour each way commuting!

He was originally talking about returning to face to face work after Easter but I'm keen to hear his thoughts now after this roadmap... It sounds like there is a recommendation to still work from home until May?

Didn't work for me OP. Tried to make it work last lockdown and didn't have the energy for it this time. Many reasons I think. I don't generally like zoom/teams etc anyway. I feel like I'm watching a video of people rather than direct contact.

There is something more difficult to describe about the space feeling different for therapy.

I decided on balance to pause the work and in some ways that fits for me because it feels like life is paused at the moment and I've lost my motivation for doing "the work".

My therapist may well be meeting some people face to face, presumably based on need. Intellectually I can see that makes sense - that others might need greater care/be at increased risk (but emotionally I'd rather not know!)

I'm not a fan of it, feel like I'm still crying on my own in a room about stuff which is no different than it's been in the past. I really want to know what he's thinking about going back but I'm scared to ask.

Really lovely and interesting to hear people's experiences. I am really glad for those of you who have found it has worked.... but also really understand missing 'that feeling' of being in the room with someone.

@Bumpsadaisie thank you for your thoughts. I really get what you mean about it being a growing experience and your words have been helpful in soothing me a bit and helping me be gentler with myself (and him!) as I go through it!

I've booked a session for Thursday with someone new and he offered to see me face to face. Although he does online ones - he appreciated that as my kids are at home and wfh too that might be for the best if I do f2f and I'm really pleased about that. My home life is fine, it's more for dealing with my drug addict brother but I feel so relieved that I don't have to worry about my DH hearing or being in the messy room where I work and sleep. I have to say it's also going to be great driving somewhere and seeing someone new.

I had another appointment last week on medical grounds for something else AND a dentist appointment. So things are opening up.

I also do a LOT of zoom. 3 today I think so on average I'd say 10 hours a week so the thought of voluntarily doing more makes me want to cry. It is very stressful

@Gerberageri its great that you are feeling the return to normal, even just a little. I hope your appointment goes well.

Can I ask those of you who've had face to face sessions during these times, are there any "covid safe" measures in place such as wearing a mask or having the window open?

My therapist is planning to make face to face sessions an option again after Easter but he isn't sure what we would do about masks etc. which didn't sound great to me (yes I have told him and discussed my feelings) - just curious to know what others do? I expect he will be vaccinated by then due to his age but I won't be so it still feels a potential covid risk...

I’ve been very lucky and had face to face therapy the whole way through lockdown since last March - so it is available but will obviously depend heavily on the individual therapist.

Sorry hit post to soon - my therapist and I had a conversation about what if any precautions I wanted to take and felt comfortable with and proceeded on that basis. We’d never sat so close for that to be an issue anyway 😂