Annals of a therapist during COVID-19: Day 1

3/26/2020

I’d intended, since I went into social isolation about twelve days ago, to write a few blog posts. Funny, uplifting stories and perspectives was the goal, because I think now more than ever, we need the ability to find joy and laughter.

And I might still do that. All bets are off.

But I haven’t yet been able to access that part of me that can pop off a funny anecdote like it’s nothing. The inside of my head is usually a ticker tape parade, colorful and chaotic and overwhelming, and often joyous. Now, though, it’s more like a funeral procession. My brain mechanics feel rusty and worn, slow and heavy, like maybe one of the gears fell out altogether and the others are having to compensate, but aren’t quite up to snuff. Like maybe the whole machine is about to go kaput.

The era of COVID-19 isn’t easy for anyone, so I’m not trying to say my mental distress is special. It’s not. I’m floundering in a completely foreign situation just like everyone around me is. Problem is, I’ve got people looking to me for help, too. I’m still a therapist, even if the world is upside down and inside out. Especially because the world is upside down and inside out.

It’s been a weird road, these past two weeks. The week leading up to Friday the 13^th of March, I was still in a state of heavy denial. The virus was just another flu. I was going to Jamaica on March 21, as planned for over a year. Over that week, I started the process of acknowledging and grieving what my losses were shaping up to be. And on Saturday the 14^th, I woke up and was like “waiiiit holy shit, hold the phone, what are you doing?” It was a strange experience, like all of these new and very real thoughts had infiltrated me and I couldn’t understand why they hadn’t been there all along. I accepted the reality and gravity of Coronavirus in a new way, and grasped my responsibility in flattening the curve. I cancelled my vacation. I got a telehealth platform set up for my practice. I emailed every client to tell them there would be changes in my service delivery. I created consent documentation and consulted consulted consulted. Between Saturday and Monday, I transformed my practice completely. It was exhausting, but exhilarating. I love learning, and I had to—and fast.

Fueled by caffeine, novelty, and optimism, I marched into last week. I saw twenty clients over telehealth, and the process went beautifully. No tech issues, and the whole videoconferencing thing felt a lot less interpersonally weird than I thought it might be. It felt empowering to be able to offer hope and guidance in bleak times. I ended the week with a sense of relief that I could still be a steady presence for my clients, put some good into the world, and also bring in some income for my family.

Enter this week. Now, I was supposed to be on vacation this week, so I opted to keep my caseload light. I scheduled nine people. I had hoped for a restorative week, filled with mostly reading and junk TV and personal stay-at-home projects. It has turned out to be a week of battling with insurance companies, intense client stress, and coming to grips with the mortality of my world. It has turned out to be a week of increasingly horrifying news, a week where I had conflict with family and friends about what “social distance” means in terms of how to enact it successfully, a week of fear and frustration and almost constant anger and anxiety. I’m trudging into Friday feeling like I’ve been steamrolled.

Today I held the sadness of a senior who will likely not celebrate the end of her high school career elbow-to-elbow with her friends. I held the desperation of a refugee who is running out of food with no apparent means of getting more, and whose children have fallen ill, possibly with Coronavirus. I held the anxiety of a pregnant mother who is unsure her partner will get to be in the delivery room with her when she labors. I witnessed the fear of my colleagues as we wonder if and how we will be reimbursed fairly for the important services we provide to others, in the age of telehealth, and I went to bat with and for them in the ways that I could.

Today I had my first panic attack in years.

Because the trauma of my clients is different than mine, but the same. I hold for them the very things I fear myself. Scarcity, financial ruin, loss, and death.

I assume tomorrow, if operating on a better night’s sleep, I will wake with a sunnier disposition. Optimism is my default, to the extent to which clients have described sessions with me as “hope infusions.”

But euthymic mood notwithstanding, I have no delusions of the next few weeks being easy. On me, on anyone. I think we’re in for some real shit, people.

And I guess until my funny bone kicks back in, I’m going to document it.

The gift of closure

Every day, life hands you a gift. Rarely, it hands you a Very Big Gift.

Sometimes that Very Big Gift comes in the form of unexpected closure.

We all want closure, right? Many of my clients are very explicit in their desire for it. One client described the loose ends in her life as constituting her very own Circle of Hell, a fiery inferno of What Ifs, I should’ve saids, ‘I wish’es, if onlys.

It’s human to crave the end of something distressful, and also to believe that we must see the end of that something to truly heal and move on. We as a society tend to like symmetry, and full circles, and clean cuts.

Yet, we live in world that’s inherently asymmetrical, the circles more like wavy ovals and rarely all the way closed, and the cuts jagged, hard to stitch up. The world we live in is messy. And despite our best efforts, we as people are messy.

It is for these reasons that I, more often than not, end up in a tough love position when my clients tell me that they need this thing to move on in their life. They need that apology. They need that validation. They need to be heard, or seen, or noticed. Need, need, need, they say, and I smile, and nod, and then say, “no, you don’t.”

You see, it’s a matter of want. We want those edges sewn up. We want to know we’ve said all we could, or that we were understood, or that there are no hard feelings. We want to apologize or be apologized to. We want the mess cleaned up, swept up, stowed away.

But we don’t need it. And in fact, I think it’s the believing that we need something from someone, in order to move on, that keeps people sunk into distress, despair, and with bad habits on repeat. When we rely on the reactions of someone else to determine our healing, we put the key to our contentment into someone else’s pocket.

Closure in the form of an interaction with another person, a certain thing you want to say or want said to you, is certainly something you can crave, yearn for, and seek out. And sometimes, if you’re really, very lucky, you just might get it. But hear this: You Are Not Entitled to It. If you get it, consider it a gift. Consider it an ultimate win.

Nine times out of ten, people don’t get closure in the form of an interaction with another person. They get it from somewhere inside of them. They learn to think about the situation in a different way. They accept that there are things that will never get to be said, or heard, or felt. They accept their lack of power in de-cluttering all of the chaos in the very messy world, and they find ways to move on with their lives. It can be done.

My life is just as messy as anyone else’s; maybe a little more so. That being said, I’ve got some broken circles hanging out limbo, swinging from branches, taunting me with their lack of completion. One of these broken circles, in particular, was not only broken, but also on fire. It has kept me up at night. I’ve cried about it, raged about it. It comes up in my dreams and I wake drenched with cold sweat and cursing my pockmarked and hypersensitive heart. And because I thought it was the best thing to do, I worked very hard at making peace this thing, internally. My gut told me that it wasn’t fair to involve the other person who held the missing link in my incomplete circle—because my circle was my burden to carry, not theirs.

I made progress. I left the circle hanging up in the branches, scorched and ashy, but no longer burning. I became able to tolerate its brokenness. I accepted it as it was.

Then I happened to run into the person who had the power to complete that tattered circle. And because I am both very lucky and also because there is goodness in the world, the person gifted me with closure. I said some stuff I’d wanted to say. I got some questions answered that had weighed on me. I felt heard and forgiven and valued, and I hope the other person did, too.

To be clear: I didn’t deserve this interaction. I didn’t earn it. I wasn’t entitled to it. It just happened. It was a gift.

I’ve still got a lot of broken circles hanging out in my branches—unfinished business and unanswered questions and points of grief and loss. It’s pretty human to have a few. And I know with a certainty that runs bone deep that many of my circles will never be closed; they’ll always be missing a piece, or bent beyond recognition, or crafted with a dotted line.

But I’ve gotta tell you: I am grateful, grateful, grateful to have one less now.