Persevering through the Pandemic: A Collective Conversation with Therapists on Struggles, Strengths and Strategies

A memory I have from childhood is staying with a beloved Aunt and Uncle during a stormy weekend in early March. As we watched the wind, lightening and rain whip through the treetops, wrapped in blankets, hot coco in our cups, the electricity out, my Aunt murmured, “March comes in like a lion and goes out like a lamb.” COVID March 2020 came in like a lion and went out like a fire breathing dragon forever changing the world as we know it.

The changes have impacted every country, person, family and organization on our planet, including the world of mental health.

Though I am an experienced Licensed Marriage and Family Therapist and a Certified Telehealth Therapist providing Telehealth sessions for individuals and couples over the last 14 years, and exclusively via Telehealth since 2016, like many of my colleagues, I did not think that we healers would be living through a pandemic, trying to navigate unchartered territory, while simultaneously supporting the clients that we care so deeply about during this unprecedented time.

When the shelter in place mandates began rolling out, the main topic of discussion during my business coaching and CSAT/CPTT certification supervision sessions was best practices in supporting clients. Many of my colleagues, coaching clients and supervisees were new to the world of Telehealth. Not only were they dealing with their own fear, stress and uncertainty about COVID-19, they were now facing a whole new dilemma - how to support their clients safely and ethically while navigating the sometimes confusing HIPAA laws that apply to phone and online sessions for U.S. therapists. For my coaching colleagues outside of the U.S., they too were dealing with personal fears and stressors while juggling professional responsibilities in supporting their therapy clients.

Soon after social distancing began, or what I prefer to call physical distancing, several organizations contacted me to provide Telehealth training through a series of webinars. These webinars were scheduled two and three times a week over the course of two months. Given all that was unfolding, I felt a deep sense of responsibility to step in to this role as saying no to these requests did not feel like an option given the pandemic and the myriad of changes happening at a breathtaking speed in the world of mental health. It was important to me to not only support my fellow colleagues, but to also help in some small way as our clinical profession shifted to the online world. Hearing that the information I was providing was helpful brought me a great deal of peace and comfort in the midst of such chaos.

While I was grateful for this opportunity, with an already packed clinical and coaching schedule, and dealing with my own fears and worries regarding the pandemic, as the weeks ticked by, I could feel my energy draining away. One night, after a 14 hour day of back-to-back therapy clients, facilitating a two hour Telehealth webinar, and caring for a sick loved one who was quarantined, I found myself staring down at the floor, messy hair, head in my hands, as I wept with exhaustion. If not for my sweet rescue kitty Stanley circling around my ankles, I may have just curled up on that chair for the night, numb, tearful and checked out. Instead, I hauled myself up, stumbled into the kitchen, fed my sweet furry friend, fed myself, and dropped into bed with a prayer, burning eyes, and a feeling of bone deep weariness in my soul.

I woke up the next morning realizing that if I was going to truly persevere through this pandemic, that something had to give and it was not going to be at the expense of my well being and mental health. This small miracle of insight gave me an opportunity to start practicing what I teach my therapy clients: That it is more important than ever to manage the expectations of others. I realized that I needed to set limits, as well as challenge a false belief that pops up now and again for me - that I must be all things to all people.

As other organizations reached out to me, I began to respond with a gentle no, and directed them elsewhere. There are wonderful resources for Telehealth, I am but one. I worked with my own therapist over a few sessions to better understand the guilt that I felt in turning away organizations in need.

I also used my therapy sessions to process some unkindness and hurt that I had experienced during the early weeks of the pandemic due to passive aggressive words and behaviors directed toward me by a couple of therapists who had, unfortunately, felt the need to put me in my place as I endeavored to help others and share important information via the webinars. Sadly, even during a pandemic, the Envious Irmas, Raging Robs, Negative Nellies, Competitive Coras and Vindictive Vics will come out of the woodwork, assume the worst, and assign motives to people who are stepping up and helping others.

A quote that has kept me grounded during this pandemic is by Mister Rogers, “When I was a child and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.” I love this quote and would add that helpers need help as well. While mental health professionals are also first responders, we cannot be all things to all people. Finding our balancing point, and honoring our energy is truly the most important gift we can give - to self, to our loved ones and to our clients. When friends have texted to request phone call meet ups, I’ve been paying closer attention to my energy, especially after a long day or week of client sessions or coaching calls. If I don’t have the energy to get on Facetime or a phone call, I let them know that I love them, but I’ll need to bookmark a call until I am feeling up to it.

I am learning to fill my own cup for a change, and it feels good to place my needs at the top of the list, especially when it comes to boundaries with the snarky folks, energy vampires, pressure pushers, and generally unkind people. I had no time pre-pandemic for that sort of nonsense, and I certainly am not going to make room for it now.

In order to create a more robust conversation, I wanted to include other mental health professionals and highlight what their experiences have been like during this unknown season. I reached out to some of the brightest and most caring clinicians that I am honored to know, a diverse group of human beings from all around the U.S. and world. I asked the following group of therapists to share a struggle and a tip they have personally and/or professionally experienced to support fellow healers, therapists, and others during this time of uncertainty. I have included their compassionate wise voices and tips below.

My hope is that what we have shared here will provide others with assurance, validation, and encouragement. I hope you, the person reading this right now, will feel the wind under your wings as we move through the weeks and months ahead - one moment, one day, and sometimes…one breath at a time.

You are welcome to add your own voice, experience and encouragement to the comment section at the end if you would like to do so. And you are welcome to share this with others as well. Though we may be in different boats navigating different waters, some waters more challenging than others, coming together to support and encourage each other with compassion and kindness is needed now more than ever.

Wishing you and those you love safety, health and peace during this trying time of uncertainty in our world.

Please continue scrolling to read experiences from therapists and healers from around the world…

Kindly and in support,
Mari A. Lee, LMFT, CSAT-S, CPTT-S, MBATT-S

• • • • • •  • • •  • •  • •  •  • •  • • • • •  •  • •  •  •  •

One of several challenges I have experienced during this time of COVID cocooning is having mixed emotions about it’s impact on me. I am physically separated from my partner (I live in California, he lives in New Jersey), I am managing family conflict, and some of my therapy clients are greatly impacted by COVID. At the same time, I feel so much gratitude to have my health, food, a roof over my head, and a career that allows me to work virtually. Because I have all of this, I am more inclined to judge myself for having complaints about my situation. In other words, my mind says "if I have complaints during this pandemic, it means I am acting entitled and not appreciative" for the things listed above.

I am working on my self-judgment by reminding myself of the “both/and” in it all – I can feel both the upsetting emotions about my situation, and it does not mean I am ungrateful for everything I do have. If anyone else is having this similar experience of thinking it is not okay to feel a certain way because “others have it worse” (i.e., minimizing your own experience), perhaps it may be helpful to practice collective compassion. There is enough space in the world for everyone’s emotions and experiences, and collective grief can become collective healing.

Christene Lozano, LMFT, CSAT
San Dimas, Pasadena, and Long Beach, CA.
 merakicounselingservices.com
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

As a gay/queer cis-gender man, I’ve had a life-long complicated relationship with many of my anti-LGBTQ Trump-supporting Christian bio family members.  As an LGBTQ Affirmative Psychotherapist, I’ve seen the profound impact that toxic homophobic, biphobic and transphobic family members can have on LGBTQ clients.  Stay-at-home orders during this pandemic can bring all this to the surface, as they have for me, and magnify our missed and healthy needs for validation, love and connection.

During this time, I decided to reconnect with my own Mother, albeit via text.  Given our history, it’s gone surprisingly well as we have a central focus of how we’re surviving this pandemic.  Sometimes social distancing, not just physical distancing, is the best option for self-preservation, regardless of whether or not we’re in the midst of a pandemic. 

This is also an opportunity to deepen our connection with family of choice which is especially important for those of us who have been estranged from toxic family members.  We are social creatures and need connection, even when that’s only possible through technology or physical distancing.

James Guay, LMFT
Licensed Marriage & Family Therapist
West Hollywood, CA.
LivingMoreFully.com
Instagram:  @jamesguaylmft
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

The current atmosphere of the world is strange and, for me, has created some fear and motivation to take advantage of the reprieve to examine what changes I need to make to transform relationships and who I want to be.

At the onset of the pandemic and the implementation of social distancing and isolation, I felt I had taken the change in stride but at some point, I felt a sense of debilitating dread, overwhelm, and panic. I was prepared to take care of my clients virtually since I had decided months ago to take my practice exclusively online. The panic, I believe, came from the imbalance in my family life and not taking the time to examine the shift I would have to make for myself and my children. I took on too much without leaning on the support of my village.

As a therapist, I always speak to the importance of setting boundaries, being intentional about using your voice, and holding space for the fear, shame or guilt associated with asking for help and not being seen as strong.

My anxiety manifested physically as shortness of breath, heart palpitations, and just feeling an intense sense of loss of control. I spoke with other therapists and used virtual resources to connect with others. Listening to their stories gave me permission to call out my own fears and really look at what I needed and request that from the people I know love and support me.

This time has helped me embrace and take advantage of the unknown, seize the time to grow, and give myself permission to use my awesome village to ask for what I need. 

Latisha Taylor Ellis, LPC, CAMS
Georgia and Florida, US
Empowered Transitions Counseling & Consulting
empowertransitions.com  
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

My world like so many others flipped March 2020. The night I sent an email to my clients advising them of the transition to Telehealth effective immediately was terribly sad for me. I had so much fear that my business would collapse. And eventually close. Collapse due to clients refusing Telehealth treatment and / or not being able to adjust to Telehealth services.  Which lead to fear that I would not be able to financially provide for my family.

Graduate school does not prepare you to run a business, during a pandemic. However, I have learned that my resilience is strong and that with the support of my spouse, friends and peers I and my business has been okay. I have learned to ask for help and support. To use my voice to advocate for my clients with their insurances and accessing my Representative to use his voice in Congress.  Most importantly I am learning more about the balance of work and life. Embracing the slow and being present with the ones I love most.

I would like to remind all of you reading this today that none of us know what we are doing right now and that is okay. Be kind. We may not be on the same boat, but we are in fact in the same storm. Reach out and seek support and if you have the space be of support to others too.

Rebecca Stiemens, LCSW-S
Owner & Therapist
Houston, TX.
abundancecounselingservices.com
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

As a trauma therapist, I have been supporting clients during a crisis in their lives: the COVID-19 pandemic. Likewise, I have been acclimating to this new normal: working from home, homeschooling one of my children, and being the primary chef serving three meals a day.  Likewise, I too have been processing the appropriate concerns, fears, and grief as it relates to the loss we are collectively experiencing. I consider myself a survivor and felt I had solid coping tools in my toolbox.

However, nothing could prepare me with the news that my only living parent received a life- threatening medical diagnosis during this pandemic. Pulling from my Survivor’s Toolbox©: I showered daily, cried, educated myself on the disease, ate healthy, and maintained a consistent sleep schedule. Additionally, video calls to loved ones, Telehealth sessions with my therapist, as well as a daily writing schedule served as the healing balm to my nervous system. If you or someone you love has received a medical diagnosis during this time or has contracted the coronavirus, my heart goes out to you.

Elizabeth A. Poth, LPC, ATR, CSAT, CCPS, BSP-1
odonatawellnesscenter.com
Hartland, Wisconsin
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

I never thought my personal needs would be so challenging versus the needs of my clients.

During the early days of the shelter in place in San Francisco,  I found myself doing a balancing act between taking care of myself and taking care of my clients who are having reactions just as strong as mine, to this pandemic. The biggest struggle was to move from live face-to-face sessions to Telehealth. The software platform was totally unfamiliar to me and intimidating. My clients liked it  even less. The second biggest struggle was my sleep disturbance and loss of workout routine and the gym. Both are still compromised.

It has now been 7 weeks since we were asked to shelter-in -place. I feel stronger.  My practice is full. My clients are not doing as well. They want normalcy back. I am trying to utilize with them, what I do for myself.  One of our greatest gifts is the ability to voluntarily choose our thoughts.

So, I choose to focus on the positive and not engage or dwell in the negative. It’s not easy. I have shared with them numerous podcasts to listen to, to actively search out the positive messages. Regularly connecting with positive people is also important. I encourage myself and my clients to make it a daily exercise to bathe the mind in positive thoughts so that it can continue to grow during this shelter-in-place. Strange days indeed!

W. Vernon Lee, Ph.D., SAP, CSAT-S
Lee Psychological Services
vernsting@pacbell.net
San Francisco, CA
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

During the first quarter of 2020, I’d been psyching myself up to announce a substantial increase to my session fees—a long overdue move, but one that finally felt right! Then came COVID. One by one, as my clients began to report financial challenges (or in some cases, outright financial crises), I encountered a gut wrenching crisis-of-conscience: do I suspend or delay my fee increase (thereby prioritizing my clients’ wellbeing over my own), or do I stick with my intended announcement on April 1 (then grapple with the guilt of increasing fees at this peak of unprecedented financial instability)?  

Ultimately, I decided on a livable compromise: (a) I announced my fee increase precisely as planned, without apology or excuse; (b) I also provided a discount code "for any clients who may be facing financial hardship,” designating it for use at their individual discretion through the end of 2020. Gratefully and graciously, my clients' response has been heartwarming: a few began paying my new fees immediately, while most have utilized the discount code. In all cases, I have peace of mind and heart—knowing that I didn’t martyr myself for the sake of my clients, nor did I proceed with "tone-deafness" to the financial realities of our shared situation.

Gaelyn Rae Emerson, CPC, ACC
Life, Relationship and Divorce Recovery Coach
womeneverafter.com 
Minneapolis, MN
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

My biggest struggle and biggest strength in helping clients through this time is my own fallibility and emotional experience. When this began, I downplayed the pandemic with clients and tried to ground them. Surely this couldn’t shut down the economy and put everyone we know and love at risk — that’s catastrophizing.

How wrong was I?  

This is more than I ever imagined. And right now, my clients’ anxiety often echoes my own.  I read articles that tickle my fear and ignite my anger too.  I have to make sure that my countertransference doesn’t bleed on their experience. And yet, my countertransference and ability to take responsibility for my own fallibility and humanness also strengthens the therapeutic relationship and felt experience that we really truly are in this together. 

Whitney Boole, MA, LMFT
Hermosa Beach, CA
whitneyboole.com
Author of You Got This: Healing Through Divorce
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Prior to COVID-19, my husband was already working 100% remote for several years, and I often worked from home anyway. As a result, our transition hasn't been as difficult as I know it has been for others. We've had to make some accommodations based on the fact that I'm home more often than I used to be. Here's what has worked for us over the duration of this time: 

We have put signs and signals in place for when we are in Do Not Disturb mode. That means when I am in a private counseling session or need time to myself, my door is closed, locked, and I have the sound machine outside the door (I often also give him the heads up on when I have confidential meetings). For him that also looks like door closed while he's focused on his work.

We've also carved out together time, alone time, and separate together time. Together time has become more intentional, where we stay focused and present with one another free from screens (these days it's sitting together in our chair and a half drinking our morning coffee or in the evening after dinner). Alone time is when we each need a break and go into our own separate spaces, whether that be one in the backyard and one in the garage, or one in the bedroom and one in the living room. Separate together time means that we're sharing the same space, but each of us is tending to what we want to do. That looks like either one of us watching TV and the other one scrolling our newsfeed, or reading a book while the others listening to music, or just hanging out on the couch together and doing our own thing. 

Having these rituals in place has helped us tremendously adjust even better to this time.

Shirani M. Pathak, Licensed Psychotherapist and Leadership Development Coach
San Jose, CA.
ShiraniMPathak.com
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

My business has been built largely on intensives with couples who travel from out of state to see me in Houston. So when the social distancing restrictions began around the country, I was hit with lots of cancellations and the need to refund deposits to clients. Fear started to paralyze me as I watched my schedule and business accounts empty.

Then I heard the words I was sharing with my clients: "Don't focus on your limitations; focus on your opportunities." The last month has probably been the most productive I've had in years, with several long term projects now nearing completion. I was able to make some quick, creative adjustments for income to cover expenses while cultivating new avenues of business to ensure I'm never in this position again.

So for what it's worth, here's my two cents: Giving headspace to scarcity and fear will keep you from seizing the moment to move forward.

Dr. Jake Porter, LPC, CSAT, CMAT
DaringVentures.com
Houston, TX.
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

One of the biggest challenges that I have faced thus far has been buying into the myth of "balance" in my roles as a business owner, trauma therapist, mother, wife, daughter, and friend. What I have learned so far is to accept the fact that, I indeed, cannot hold all of these roles simultaneously.

Furthermore, responsibility to myself and my own mental, physical. and spiritual health needs to make it on the "role" list first and foremost. I am learning that multitasking is not possible for me at this time. I simply do  not have the bandwidth.

What I am learning to do, and I encourage other therapists to do, is to try your best to turn your other roles off when you are actively engaged in one and give yourself fierce self-compassion when the lines do (and always will) cross. 

Erica L. Wilcox, MS, LPC
wilcoxwellness.com
Founder/Director of Wilcox Wellness Center for Personal Growth
Certified EMDR Therapist and EMDRIA Approved Consultant in Training
Southington, CT
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

I have found it challenging to help clients who were already working through traumatic events in their lives in therapy through this time. I noticed my own system was quite activated and even had my own struggles with re-regulating for the early part of this crisis. I wanted to hold space and be present for them.

I initially was hard on myself but I started reminding myself that this is co-regulation in therapy, rather than me being paid to regulate them. So I started centering to it being a collaboration during this challenging time. I found them (for the most part) to be kind and flexible. This helped me regulate, orient to balance and ok-ness, which in turn helped me be an even better regulating system for them as well. And now it’s been easier to concentrate and be as supportive as I want to be.

Dr. Michael Salas, PsyD, LPC-S, CSAT, CST
Dallas, TX, vantagepointdallascounseling.com
Author of, Bridging the Sex Addiction Divide: Mindful Considerations for Vulnerable Clients
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

After COVID 19 our planet will never be the same! And… I really hope it isn't. Humanity has stepped off the “crazy” wagon, albeit for a minute. It's been confronting, frightening, enlightening and eyeopening. COVID has forced a global situation where we must examine what is important, like it or not. Some have been dragged in kicking and screaming, and some have taken to it like a kitten in a warm beanie. 

After WW2 women were not going to be forced back into the home after being given a leave pass to freedom. Fast forward 75 years, the corporate treadmill has become a prison, need more, work more, connect less. Interestingly, COVID has put us all, men and women, back into our homes, connecting, fighting, loving, take your pick. COVID has opened the doors to a new humanity, a new freedom, if we choose to see it as an opportunity. It's shown us that we can work from home, we can juggle our time, both parents can raise their children, in short, 9 to 5 no longer needs to rule our lives. 

Will it be easy? No, the learning curve never is, but I hope we will dare to do things differently. Many of my clients have proclaimed; "I am so grateful for my recovery, I am not sure where I would be without it.” So am I… truly deeply, madly and passionately.  Like many of my clients, I am afraid to be derailed back into the chaos of "before.” I am not stepping back onto the crazy wagon, my priories have changed. Instead, I pick love, connection and kindness. Work less, work smarter, love more, love harder. Together be adventurous.

Rebecca Higgins, B.App.Soc.Sc (Couns), CSAT 
Clinical Director The Radiant Group, theradiantgroup.com.au
Richmond NSW, Australia
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

I'm the owner of a group practice that is home to seven separate therapy practices. When everything began shutting down in mid-March at a rapid rate, I quickly learned that we all had different comfort levels with how to run our practices. Our state guidelines (Utah) weren't as clear and directive as other states. Though everyone was respectful, there was real tension and fear about how to stay in business, serve our clients, and protect everyone's health.

As the owner of the building, I secretly wished someone would just tell me what to do. I was afraid I would be too strict or too lenient. I respect every one of these therapists and I felt that it was more important to give everyone a voice until we were all heard.

Though it took longer than I had anticipated, it turned out to be a very calming and connecting experience that allowed us to make a unified decision for the building. I learned that decisive action doesn't have to only be unilateral. In fact, deciding quickly to hear and value each person's fears, observations, and contributions allowed us to pass along that security to our clients. 

Geoff Steurer, MS, LMFT
St. George, UT 
geoffsteurer.com
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

During this pandemic, I’ve come face to face with my internal, and perceived external, pressure to make good use of this time.  To be productive, create, and get big things done -- a work project, cleaning and organizing that hall closet, reading my stack of books that await.

What I’ve learned is that, while this is a good idea, desired, and societally condoned, it may not be where my authentic energy lies.  Motivation for me always comes in waves and I have to ride the wave when it’s here.  And, most importantly, during this pandemic it’s been normal to feel waves of being preoccupied, more tired, more scattered, less focused.  It’s definitely different than my non-pandemic energy patterns.  

To best navigate this time, I’d like to recommend we all recognize and embrace our authentic energy patterns, no matter what the internal, and perceived external, pressures may be. 

Sona DeLurgio, Psy,D, LMFT, DrSonaDeLurgio.com
Psychoanalyst and Marriage & Family Therapist
Westlake Village, CA
Author of: Finding Peace With Food and Your Body / A 5-Day Deep Dive Guide
drsonadelurgio.com/products/fpfb
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

This pandemic brought me face-to-face with a powerful, triggering experience - providing online therapy to my male sex addict clients via video chat. I am in recovery, and engaging with men online was my primary mode of acting out!  It was instantly triggering to see these men on my screen sometimes up to six hours a day. I have been sober for seven and a half years, and I wasn't ready for this challenge.

As such, it became clear I needed to implement new guidelines to support my well-being when clients presented for sessions in their bedrooms, sometimes in the actual bed. I felt uncomfortable, and these sessions became increasingly challenging.  After two weeks, I was emotionally fried.  

I received support and encouragement to outline new Telehealth guidelines for all my clients, which included wearing appropriate attire, not being under covers during a session, and not using substances (marijuana, cigarettes, or alcohol). I also outlined that it would be inappropriate to meet while the client was in the bathroom or driving.

I stressed the importance of treating these sessions as they have always been - medical appointments. My guidelines were accepted with no pushback. I feel more confident in moving forward as a Telehealth provider. My recovery feels stronger, and it's because I feel safer.

D.J. Burr, LMHC, S-PSB
djburr.com
Seattle, WA
Author of, “I Just Wanted Love: Recovery of a Codependent, Sex and Love Addict” 
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

The biggest challenge I have faced while working from home full time is having my 6 year old home with me. With school and summer camp cancelled this is my new normal. She is 6 (her "quarantine birthday" was last week) so she can't entertain herself for long periods of time. I've had to adjust my schedule and NOT do back to back sessions as well as do more evening sessions when my husband is home to wrangle our tiny human. Most sessions have had at least one interruption and one ended with her snuggling in my lap (with my clients approval, of course...and headphones so said child couldn't hear.) 

The gift has been my clients complete understanding and flexibility. We are all in this together and they get it...and I'm so grateful. 

True story: I was doing a phone consult with a couple and my child burst in the room and screamed "Mommy! There's a spider!!!" I had to attend to the arachnid situation while trying to describe Formal Disclosure and it was a cluster ****.

Fortunately they were also parents and found my transparent humanity refreshing and amusing. They said I was perfect for them and they have become clients. My clients have now all been privy to my "Mom" side and, honestly, I think it's strengthened our rapport and appreciation of one another. It's definitely a big challenge but so far we are making it work. 

Jill Vermeire, LMFT, CSAT-S
loverehab.net
Phoenix, AZ
••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Teaching death, dying, grief and loss to therapists and allied health professionals, and doing grief work with clients is my professional self, while personally  I’m married to a funeral director who is also with the National Disaster Medical Services (NDMS) as a member of the Disaster Mortuary Team (DMORT). We live grief days, nights, weekends - for us it’s a natural part of our days and lives. My fear as we watched COVID on the other side of the world and heading our way was that neither the therapeutic community nor the stoic, insular mortuary and coroner teams were ready for what was becoming an onslaught.

Nobody could truly be ready for something we hadn’t seen since 1918.

I heard from morticians struggling as things got more intense, and I talked to therapists who were trying to cope with deaths in their families, deaths of clients and in client families, helping first responders in an unprecedented event, and trying to figure out how to balance their own needs and  how much transparency was too much versus not acknowledging how this was impacting them. I knew I needed to be part of the helping with that while reserving energy for myself, especially since I came down with the virus.

If you are feeling stretched too thin from helping and struggling to maintain your balance, I found using the new technology approaches made that possible: Zoom classes for professionals to reach the maximum audience; Zoom groups to capture those needing support; videos about the issues coming up posted where they can be found; blogs on my websites and social media that cover concerns and fears being voiced; an online teaching platform and website where anyone can find information and ask for help. It gave me back some of my time, my focus, and some much needed space to take care of myself and my wife which is an absolute necessity for all of us.

Jill A. Johnson-Young, LCSW
Riverside CA
jilljohnsonyoung.com
Author of, “Your own path through grief: A workbook for your journey to recovery “ ,
and, “Someone I love just died: What happens now? “

•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

During the first few weeks of COVID-19 pandemic, I truly struggled with moving my clients to Telehealth. It brought up so many thoughts and feelings in me. Many colleagues were moving quickly to Telehealth. Prior to this crisis, I viewed Telehealth as second-best to meeting in my office. So, the prospect of moving to Telehealth caused me fear and pain as I anticipated that my clients would be unhappy and not get fully what they needed. I feared they would be more likely to have relapses or decompensate in some way. I also questioned the ethics of moving to Telehealth. As a therapist and social worker, I am an essential worker. It seemed like it was my responsibility to be there for my clients, regardless of the circumstances. After all, consider the healthcare workers who are placing themselves at risk. So, I asked myself, “Is it selfish to insist on Telehealth, especially when the client isn’t very concerned?” Without understanding my worries, several colleagues even stated they believed it was unethical to continue seeing clients in the office. What a significant dilemma I was facing.

Once I was able to define my struggle through realizing why this was a difficult transition for me, I was able to adapt rather quickly. I began to consider the risks, which also had extreme ethical implications. For example, what if a client transmitted the COVID-19 virus to me? I could then give it to others unknowingly. I would then need to inform others and accept that my actions had exposed them. I also thought about what contact tracing might mean and the implications for client confidentiality. I became very uncomfortable considering these possibilities. After discussions with other therapists (and Mari’s training), I moved to a full schedule of Telehealth, rather than office, visits. Key to my successful shift into Telehealth was viewing Telehealth not as second-best, but instead as a different modality. With the right attitude and energy, Telehealth could likely be just as good as in-person meetings.

After I changed my outlook about Telehealth, my energy changed too. I began to bring more enthusiasm to the sessions. I started using the same types of therapy, such as EMDR, Brainspotting, and experiential work in the sessions. I stopped thinking about Telehealth as second-best and started experiencing it as an additional powerful tool. 

I tend to be more comfortable with in person one-on-one interactions, however, I have learned that Telehealth sessions are one-on-one. In fact, with a good video setup for you and the client, you can see each other very clearly. I notice the same subtle facial changes that I notice in the office. In fact, I have experienced some very powerful client work over the last several weeks. Clients are adjusting too. A few still prefer office-based meetings. But many appreciate the convenience of a session where there is no commuting.

A tip I would share is to open your mind. Consider Telehealth as another important tool that can actually improve your client work and enable you to reach more people. Face your discomfort and fear. We ask our clients to lean into new experiences; we must do the same.

Dr. William Feuerborn
DSW, LCSW, CSAT, CSAT-S
Long Beach/Irvine, CA.
williamfeuerborn.com
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

It has been overwhelming to transfer my client caseload to online therapy. The learning curve has been very steep and daunting. My doubts and anxiety are challenged daily.

As I try to assist my clients to reach their treatment goals, I also strive to help my clients get the most out of their online sessions. I want to make meaningful connections and experiences for my clients. So to optimize client sessions, if an online connection is lost, my client displays/show their “meaningful item” for ten seconds to help reestablish the therapeutic presence.

And finally, to challenge my doubts and anxiety, I don’t look back. I remind myself daily to trust the process and my skills as a therapist to use the platform that has been appointed to help people.

De Angela Smith, M.A., AMFT
cavfamilytherapy.com
Huntington Beach, CA.
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

My initial anxiety after learning about COVID-19 was for myself and family, how it was going to impact us and how long it was going to last.  Soon after, I looked past myself so that I could understand this pandemic’s meaning and purpose. 

Believing in a higher power, I began to realize that this was an opportunity for all of us to learn what can be avoided if we make the choice to live in a more caring and mindful manner.  It is our planet bringing our attention to how we mistreat it, and how we sometimes mistreat one another. A warning of what can be avoided if we make the choice to live in a more wholesome, caring and mindful manner.  It is our planet bringing our attention to how we abuse it and how we sometimes mistreat one another.

The pandemic is showing us what the future will look like if we do not take heed. This gives each of us an opportunity to make different choices to save our planet and our species by being more conscious and aware.  By thinking this way, I manage my stress by looking to the future and to controlling what I can control.

Keep well and stay safe.

David Feder, MSW, RSW, CSAT, EMDR (Levels 1&2)
Registered Social Worker, Psychotherapist
Toronto, Ontario, Canada
closeconnections.ca
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

During the first several weeks of COVID-19 I was so focused on the crisis of the moment that I did not realize the coming struggle, the struggle to transition to working from home. I had no awareness around how much my daily ritual of rising, showering, meditating, then hopping into my car and driving to work helped me transition into “work mode.”

Once the initial crisis of converting all of my clients over to Tele-health, updating the intake paper work for Telehealth, and supporting my clinical staff was behind me, I began to notice I was feeling less and less motivated. I have suffered with depression my entire life, and this feeling of darkness rising inside of me caught me off guard. An important part of how I manage my depression is with my mindfulness practice. That’s when it hit me, when I moved to meet the crisis of this moment, I had dropped my meditation. This realization was an eye opener as I have consistently meditated for decades, and now more than ever I needed to get back to my practice.

I began to practice what I encourage my clients to do when they realize they have not been practicing an equanimity in relationship to mindful living and what is called the eight domains of recovery: Sit down take a deep breath and go back to the basics. Sitting down taking a deep breath and going back to the basics is what I would encourage us all to do in times like this. When the world has been turned on its head and we feel like the very society we serve has failed to notice we therapists are also “first responders” , the best gift we can give ourselves and each other is to reflect without judgment for self or others, and practice compassion and permission to be human. When the mind becomes reactive, it is a gift to practice non-reaction.

We can do this by:
1. Setting an appointment in our calendar to sit in meditation, or even noticing the breath.
2. Slowing down when we eat. Take a minimum of 30 to 45 minutes to eat. Notice the way your food tastes. Chew your food thoroughly.
3. Avoid caffeine or at least cut back. Many of us don’t realize that when we are not out and about we need far less caffeine. Staying hydrated with water is important. Even 15% dehydration impacts mood and concentration.
4. Practice gratitude. During your day as you are working look around your home and appreciate what you have done. You have worked hard and built a safe place. You have done this by caring for others. You have spread hope, connection, healing and love through your work. This is a huge accomplishment in this day and age. Give yourself credit for this.
5. Allow your-self the permission to say no. We often find it easier to say no when we are working from an office. We notice the time it will take for us to “drive home”, etc. We need to realize that just because we are working from home this does not mean we have to work all night from home. It is all about structuring a schedule that works for you in a gentle compassionate mindful manner.

These may seem like five very basic things, and that is because they are. That is what I mean by going to the basics. We know from the research Richard Davison, Jon kabat-Zinn and many others have done that there is no substitute for these five basic steps.

The MBATT Certification (Mindfulness Based Addiction and Trauma Therapist) trainings we do at The Mindfulness Academy for Addition and Trauma Training are designed to support our fellow clinicians in adding researched based tools and techniques, including the eight domains of recovery, to support the work they do in helping hurting people heal. The basics as outlined above are all we need for this moment with our self.

With Compassion and Respect,
Darrin Ford, LMFT, CSAT-S, MBATT-S
Author of, “Transforming the Addictive Mind”
The Mindfulness Academy of Addiction & Trauma Training
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

Change is difficult for me. When the pandemic hit, change happened swiftly and from every imaginable angle: sheltering at home; not going to the office to see clients; not able to see (and hug) friends and loved ones; upending of daily routines. Then my wife decided to cancel DIRECTV. And for some reason, this was what broke me. I was originally on board. I shouldn’t be watching so much news anyway. But I found myself really missing my daily ritual of watching CNN and connecting with my new group of pandemic friends: Anderson, Don, Sanjay, and Chris. Suddenly not having these guys around felt like a loss. This one little change was all it took to set me off. I cycled through feelings of sadness, worry, and irritability, which felt ridiculous until I realized what was going on. Sure, it was a minor change. But change it was. My wife's decision to cut the cord had also unwittingly snipped one of the tethers I had put in place to structure my pandemic days. 

It doesn't take much right now for any of us to feel untethered. It's okay to reach for comfort where you can find it. Daily routines--as silly as they may seem to you--can serve as touchstones during this time of uncertainty. My wife found a way to stream CNN live and I'm happy it's back. When I'm watching it now I'm thankful not only for the familiarity of the on-air personalities but also for serving as one of my coping skills during this pandemic. We all need our daily comforts right now. I'm pretty sure Dr. Gupta would agree.

Paul Inglizian, LCSW
Sherman Oaks, CA
hopecoastcounseling.com
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

A famous quote of Donald Rumsfeld is "There are known knowns; there are things we know we know. We also know there are known unknowns; That is to say we know there are things we do not know.  But there are also unknown unknowns - the ones we don't know we don't know.  It's the latter category that tend to be the difficult ones." 

The last part of this quote speaks to my challenge in this pandemic of how to cope with the part of my experience that language fails to articulate…those things that "I don't know that I don't know”, the ineffable core emotional truth at the heart of mine and others experience.  Building capacity to wait and be patient in these unknowns is really difficult.  There are so many unknowns in this pandemic.

One way I attempt to get closer to “knowing”, if that’s possible, is by being in nature.  Nature has this fascinating way of communicating deep truths about existence, life, patience, beauty, and joy if we lend our ears to hear.  So I invite you to join me and Bill Wordsworth on an imaginative nature walk of words.  May it help you build capacity to sit in your own unknowns, especially if nature is not currently assessable to you:

I Wandered Lonely as a Cloud
By William Wordsworth

I wandered lonely as a cloud
That floats on high o’er vales and hills,
When all at once I saw a crowd,
A host, of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze

Continuous as the starts that shine
And twinkle on the milky way,
They stretched in never-ending line
Along the margin of a bay:
Ten thousand saw I at a glance,
Tossing their heads in sprightly dance.

The waves beside them danced; but they
Out-did the sparkling waves in glee:
A poet could not but be gay,
In such a jocund company:
I gazed—and gazed—but little thought
What wealth the show to me had brought:

For oft, when on my couch I lie
In vacant or in pensive mood,
They flash upon that inward eye
Which is the bliss of solitude;
And then my heart with pleasure fills,
And dances with the daffodils.

Kelly Bentz, MA, LPC, CSAT
Portland, Oregon
Bentzcounseling.com