Along with the challenges, COVID-19 has brought new discoveries to both clinicians and patients

COVID-19 has changed so many essential elements of psychotherapy. At a time when individuals in therapy want more than ever to meet face-to-face, social distancing does not allow it. Teletherapy (phone or video) is being practiced instead, but with significant challenges. Privacy is crucial to the therapy process, so some sessions are being conducted in parked cars, locked bathrooms, and backyards. Babies and pets have been welcomed into sessions.

The overloaded and primitive technology of video/Zoom sessions poses an additional challenge: breaking up, freezing, and numerous instances of “I didn’t hear you, could you please repeat what you just said.” Instead of the attunement that is so comforting in a good face-to-face session, we are experiencing a mismatch between the visual and the audio that can be quite unsettling. This week I conducted a session with video for visual and phone for audio — still a compromise, but at least the sound was clear.

We need feedback from our patients about what is and isn’t working for them; we need to remember to ask for it.

Along with the challenges, COVID-19 has brought new discoveries to both clinicians and patients. I would have predicted that individuals in treatment for anxiety disorders and particularly OCD would be having a very hard time. In fact, they are doing better than expected, and in many cases better than those for whom anxiety is a new experience. They suddenly feel “normal,” which has diminished the shame and self-criticism that can accompany an anxiety condition. They have the resources and skills that they had gained from their treatment. They have been through a lot and they know that they can survive.

Our patients are also making new discoveries about their latent strengths. Those who are sheltering alone are realizing both the positive as well as the negative effects of solitude. Single women were thrilled to discover that they were capable of conducting a beautiful and meaningful Seder. On the flip side, Shabbos can feel particularly lonely when sheltering in isolation.

Another type of discovery: Individuals who had not reached out for help in the past are realizing that they could benefit from psychotherapy. Relief Resources has conducted a survey, and has a database of therapists who are conducting teletherapy and are accepting new patients.

We depend on our roles in life for a sense of identity and purpose. These roles may include the role of grandparent, active participant in the classroom or shiur, or breadwinner. Many of us are unprepared for how unsettled we feel when we cannot act within our familiar roles. But we’re finding that from that experience of unsettlement comes new realizations. Perfectionists are observing that they can tolerate a relaxation of standards. Workaholics are recognizing that relationships matter, that we are humans who need to connect, not work machines. And people are discovering that they have a new gift to offer, the gift of listening, the gift of checking in with people they care about.