Phone Off or Phone On? The Meaning of Mobiles and Impact of Images

During a recent holiday in Scotland, I woke up with an image of a Syrian street after a bombardment. I had been reading a book about Syria the night before, but I realised quickly that this was an image I’d seen on a client’s mobile.

As therapists we tend to assume that clients will turn off their mobiles during a therapy session, usually without a need for discussion. For most of my Syrian clients, though, their phone remains a constant companion. It is a record of a life lost and a source of news about Syria and the countries families have fled to.

When I began working with Syrian refugees, I quickly became aware that I needed to request that mobiles are turned off in therapy sessions, explaining why therapy is less likely to be helpful if we are interrupted. For some clients, this has been hard, and the request has been denied. Turning the phone off is too much to contemplate. When we have explored why, it often relates to a need to know that family can reach them.

On one occasion, as I began Eye Movement Desensitization Reprocessing (EMDR) preparatory work with a client, I had to insist he turned his phone off. Once we explored what EMDR processing would involve, my client was able to understand why. But the thought that he was not available or responsible for his family in an emergency was hard for him. It tapped into some underlying guilt he felt about who he had left behind, as well as other decisions he had made about the timing of his journey from Syria. The need for clients to always be available is linked in part to this never-ending war, and how far and wide families have been scattered.

I am still learning about this, and trying to be more thoughtful in managing these conversations. When we do agree for the phone to be turned off, clients have valued the impact of 50 minutes free from the constantly shifting contact of social media and relentless news streams.

In my supervisory, therapeutic and management roles, phones seem ever present now. Clients want me to witness the impact of the shelling on their house; show me how much their sister resembles a daughter; share the skill of their craftwork… or just for me to see who they ‘were before’ and what their life was like: look at these tiles, our farm, my shop. It is important I witness these images. However, I am always aware that sometimes what I am being asked to look at might be difficult to witness.

One young man wanted me to see an image of his uncle who had raised him. I had expected a picture of an older man, perhaps at a celebration, not a dead body. I learnt a lot from that moment.

I now encourage those I manage and clinically supervise to think about whether they choose to look at images on phones, however important this might be to a client. An activist engaged in a political struggle might insist you see footage of a public hanging and feel angry that you decline to witness these atrocities. But, looking at such imagery impacts on us as therapists and can affect how we manage the rest of the session in a very immediate way.

As well as protecting ourselves, we need to also prepare and protect the interpreter from looking at such images, as often a phone is passed to the therapist via the interpreter. I remind my interpreters to gently signal to a client to pass me the phone rather than show the image to me via the interpreter. My interpreters know now not to look, as often the photos are scenes they are all too familiar with.

Before this recent break, and the image I woke with, I had thought that I could manage this repeated exposure and felt that the images rarely stayed with me for long. Now I ensure that I prepare myself for every image and seek support when an image sticks.

For therapists that choose not to look at photos, it can be helpful to prepare some words to explain your decision. Whatever we choose to do as therapists, there is a loss to the therapeutic relationship in not sharing these moments but a cumulative impact on us personally when we do.