I walked into my therapist’s office for my usual Tuesday appointment and sat down in my usual spot. We exchanged the normal pleasantries before she said, “Irene. We need to talk.”
My brain screamed the loudest, “Fuck,” I ever heard rattle through my skull. I knew what was coming.
She was going to temporarily switch to seeing clients online because of the coronavirus.
“What are your thoughts about this?”
My thoughts? Fuck no. Abso-fucking-lutely no. I’m not going to fucking do it. Fuck it. I’ll become a homeless alcoholic instead.
“Well, my first reaction, as you probably already guessed, is fuck no,” I said. She asked a lot of questions. As usual, she was far more reasonable than me. She asked me to at least consider it and we would sort everything out on Thursday.
“Just remember to bring your laptop with you and we can get everything set up.”
I thought that was mighty presumptuous of her to think I was going to say yes. I had already researched all the reasons telehealth, or whatever the hell you want to call it, sucks. I also knew if I didn’t agree, I would have to stop therapy until we could return to in-person meetings.
On Thursday, I was her only client that hadn’t already switched. To allay my concerns about appointments through a computer screen, my therapist offered to have a weekly phone check-in or a longer, once-weekly online session. I felt like shit that she was jumping through bullshit hoops to accommodate me. I think we both knew neither of those options were going to work. I said no.
In the two days since I had seen her, I researched the company she was using, its security measures, which of their employees would have access to my data, their encryption methods, and how their system worked. I couldn’t use this as an excuse. They met, and sometimes exceeded, my personal criteria for what a secure system should be.
I’ve been doing this thing for a little over a month. I’m still doing my twice-weekly sessions. I fucking hate every moment of it.
An important part of my therapy is working through trauma. I can’t do it through online. It’s not feasible. We are working on other things I need to work on, but a lot of it is either directly or tangentially related to my trauma work.
For me, I need a safe place to be in when doing trauma therapy. My home office isn’t that place. It is a place where I feel safe, but it’s not a safe place to be discussing such things. The safe place I need right now can’t be replicated over video.
The sessions where I work on my trauma are often intense and can sometimes trigger other things. My therapist is extremely adept at recognizing when I need a break to just cry, when I need to break to breathe, when I’m overwhelmed, and when I have had enough. You can’t do that over a laptop screen which only shows my head.
Video fails in another way. Often, I will sit in my therapist’s office and stare at a specific spot. This is a massive cue I am trying to formulate and answer or am processing a question or thought. You can’t see that through a computer screen.
My therapist also can’t see if I have one of several items I carry with me to calm myself down. She can’t see if things are starting to go awry. She has no idea if I have become silent because whatever we are discussing is overwhelming or if I am simply trying to formulate a reply to her question.
This is not how I interact. It’s not how therapy was meant to be. I’ve read the articles about how therapists and clients are working to adapt. I’ve tried. After about a dozen sessions online, it simply doesn’t work well. The fact that it is the only solution for everyone is highly frustrating.
Telehealth is not the same experience or the same therapy I receive in person. It has an added layer of stress I experience twice a week. Before being confined to therapy via video, I got to spend fifty-seven minutes in my car traveling to therapy. In the silence of my car, I prepared for the topic at hand. When I left my therapist’s office, I had another fifty-seven minutes to process what was discussed.
Now, I am disturbed at home by many things – cats, texts, a husband, loud neighborhood children, ambient noises – distracting me before and after my therapy sessions. It’s not the fault of anyone, but it does affect how well my therapy is going to be.
The work I do in therapy is exhausting enough. I didn’t need the extra stress of noise and computer screw ups. I have only had one session where there was not a problem with the connection. When I log on, I have to test my camera and sound. It works fine. When my therapist connects – boom. No sound. I have to log off and log back on, sometimes more than once.
Most people will keep trying until it works. My brain doesn’t work that way. In between the curse words, I have to stop and calm myself. When this happens several times in less than five minutes, I get angry. This is not how anyone wants to begin a therapy session. I end up spending ten minutes talking about bullshit as I try to calm down.
Because everything is done through talking heads on a computer screen, my therapist and I interrupt each other. Then, we must have the polite dance of, “no you go ahead,” which wastes time and detracts from the issue at hand. It’s aggravating, but there isn’t any way to eliminate it from happening.
During this time, I also had a major setback. A friend and my therapist told me not to beat myself up over it, but I keep running the scenario over in my head. Would it have been different if I could discuss the flashbacks and continue my trauma work in therapy? I honestly don’t know. I’d like to think the setback would never have happened if I wasn’t already feeling overwhelmed with trying to do therapy through a computer screen. Reasonably, I can’t continue to ask questions which can’t be answered. I can only keep going, learn from what happened, and move on to being better.
I am grateful I can continue the therapy I need right now, but telehealth is not the answer for me. I absolutely look forward to the day when I can, once again, drive to Alliance, sit in my therapist’s office, breathe, and resume the work I need to do.