Being Therapists During a Crisis

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At the time of writing this, COVID-19 has challenged and changed a lot of the basic routine and structure of our everyday lives. Some of us are having to continue to work in places where we do not feel safe. Some of us are working from home and are hoping the dust starts to settle on figuring out how to stay focused and organized. The kids are home and restless and we don’t blame them. Our spouses are seemingly everywhere and we’re trying to figure out how to handle our connection. Or, maybe, we’re now stuck at home and we’re alone, and the space around us echoes. And, throughout this, some of us are also therapists.

Despite the many crises and traumas we hold space for our clients through, it is seldom that we experience the same crisis and struggles in our own lives at the exact same time they experience it. We’re all facing new sets of challenges but we’re doing it at what seems like the exact same time. How can we continue to do our vital work in supporting them when we’re going through it too? Here are some ideas which may help.

Draw on the resources you do have.

Even though the events may be the same, we most likely experience them in different ways. We may even have ideas to share with our clients about parts that aren’t tripping us up quite as badly. Over the past few weeks, for example, I’ve come to realize I am much more acquainted with and adapted to both social isolation and working from home than I’d anticipated. My colleagues and friends were talking about their difficulties in keeping focused on work. So I stopped, sat down, and thought about why I wasn’t having the same trouble. I thought of some the ways my husband and I organize our work schedules in the same space, and I thought about the tricks I’ve picked up to get myself through online schooling and work despite completing it in my room and the delightful garnish of adult ADHD on top of it all. Then I wrote a blog post about some of those tips and shared it. You undoubtedly have adapted to some of today’s struggles in ways that others have not yet.

But perhaps the parts your clients are struggling with are, in fact, your struggles too right now. Maybe you don’t have those lived adaptations and tips and tricks. You do have your education and experience as a therapist through a multitude of underlying issues. How do you normally support clients in their anxiety? Their grief? Their depression? Their difficulty coping through life transitions? When we take off the specific details of what they’re experiencing, the bones are the same as they’ve ever been. We can still support them in their uncertainty and value-finding, meaning-building, in a difficult period of life. Even if we dig to the bottom of our barrels and feel as though we’re out of tools, we have one simple fact to remember: the space we hold for them and the connection we build empowers our clients to do the work for themselves. Sometimes just being there is the “right thing” to do. So what about when we feel so full, and even being there is tough for us?

Take the role of leadership.

The therapeutic relationship holds a power differential due to the influence we may have on our clients. That power comes, of course, with responsibility, and sometimes that responsibility means making hard decisions on the structure and routine of our profession. Think back to grad school, when we learned about the battle for structure and the battle for initiative. We need to be in charge of the structure so they have room to focus their initiative and their growth.

What could this look like? If you want to encourage people to stay home and you don’t want to drive back and forth to the office at random for various sessions, this can mean making the decision and telling your clients you are doing teletherapy or pausing sessions for now, rather than waiting for each client to choose for themselves. Perhaps you need to provide referrals and recommendations for if they need other options in the meantime. If continuing to work the same hours as you did before is too much with family and self and everything else you may be dealing with right now, maybe it’s the decision to cut back. And if you feel compelled to do so much more right now, make those decisions and put yourself in the right places to perform. We need to be in charge of the structure, not because we’re some dictator in an arm chair but because when we make structural decisions about our business, our clients don’t have the burden of making those decisions for us. We protect their healing and growth and keep the decisions about our business in our own hands.

And, of course, we are leaders when we model the behaviors our clients need to see. We need to make decisions, both personally and professional, which show our examples of self-compassion, mindfulness, and boundary-setting. Yes, we are professionals here to help. And yes, we have to balance and refuel accordingly so we can continue to help, rather than burn out and risk harm. Are we eating right? Sleeping enough? Exercising? Reaching out to social and colleague support? Taking time for self-kindness? Investing in our own well-being? While it may change the expectations our clients have for their work with us right now, seeing us advocate for our needs and their safety is invaluable.

Combat long-term trauma.

There’s a difference between a potentially traumatic event and sustained, long-term trauma. What seems to translate a traumatic event into an individual’s long-term trauma is their experience of the crisis as personalized and isolating. For example, all Houstonians were impacted by Hurricane Harvey but were not necessarily traumatized in the experience. For those who were, they likely did not feel the community support and connectivity others did. They likely felt isolated and alone by something that happened within those events. Someone who is, say, attacked by an assailant is also more likely to experience long-term trauma effects because of how isolating and selective the experience can be. There is something about shame which gets tangled up in trauma, and as Dr. Brené Brown has said,

“If you put shame in a Petri dish, it needs three things to grow exponentially: secrecy, silence and judgment. If you put the same amount of shame in a Petri dish and douse it with empathy, it can’t survive”

As such, continued contact with others is so important right now. It’s also a lot harder because of the constraints of current disease prevention. Who can you reach out to and connect with right now? Friends? Colleagues? Family? Utilizing any technological tools you have to stay connected in your experiences is important, now more than ever.

Look to those who’ve done it.

Ultimately, there have always been populations in the world and in our country who have always experienced some form of what we’re going through now. Uncertainty, lack of resources, inundation of difficult information. Social isolation. Lack of appropriate medical care. Disregard for their humanity. As sad and sobering as this is to consider, it also means there have always been people pushing through the difficulty and living. Finding ways to thrive in unlikely spaces. This is a fantastic time to learn more about what they have experienced, how they have continued forward, and respectfully learn how we may do so as well as we connect in our shared humanity.

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