Caring Through Crises: How Therapist Anxiety Might be Manifesting

Sarah Van Gogh

24 March, 2020

Panicky exchanges about preferred online platforms have been common among therapists this week. Worrying over details may be a distraction from our primal anxiety in the face of the Covid-19 pandemic, says Sarah Van Gogh – who offers some grounding for those experiencing hopelessness and overwhelm as we continue to care for clients through this crisis.

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Therapy, like so much in recent weeks, has had to suddenly change and make enormous adaptations. Therapists, like those in a variety of other professions, have been hit hard. Some of us have faced an overnight drop in our income. We have had to move to an entirely different way of working, where online sessions are possible. Where they are not, we have had to abruptly draw some work, for example in schools, to a close, leaving some vulnerable clients with no chance to have been prepared for this ending and loss. 

There is a ‘nesting’ structure of shock within shock, to many therapists’ experience at the moment. Like those matryoshka dolls which fit one inside another, we are feeling the primal impact of our own anxiety, upset and anger about our health, our finances, our basic supplies; and then also, we feel for our most loved ones’ difficulties; then those of our clients, supervisees and students; then those of our colleagues; those in our community; our nation; and ultimately our global community… the ripples of pain go back and forwards, from micro to macro, and back again. 

We are a nation that is used to a high level of individual freedom, and a paradigm of a have-what-you-want-when-you-want-it approach to daily life. Now that the crunch has come and people find they urgently need a well-supported NHS and proper statutory social support, the population’s mental health has been severely impacted by this brutal wake-up call about the limits of an ‘I’m all right, Jack’ way of life.

As people who have a tendency to sensitively attune to others, and who have refined this by training to enhance our capacity to do so, many therapists are at risk of feeling overwhelmed and helpless, as we open to the sheer scale of suffering, hardship, and what it all means in the longterm.

I think that one manifestation of therapists beginning to feel overwhelmed is the tone of some recent ‘virtual’ discussions about the best form of online communication to use for client and/or teaching work. Email discussions, and online forums have been full of rather panicky exchanges about the pros and cons of Skype, Google-hangouts, VSee, Zoom, etc. People are asking which is the best and most professionally sanctioned method, and others are immediately proffering opinions and information about this, with the anxiety in the exchanges absolutely palpable.

It might be helpful to do a bit of grounding around this. As Jung pointed out, no one can be spared the agony of the ethical dilemma. Each of these modes of conducting online therapy has their pros and cons, and most professional bodies recognise this. I was heartened to read in some recent NHS guidance that the Information Commissioner would not consider pursuing an individual therapist for a risk to breaches in confidentiality, if they ran a session by Skype when that was the only online method that a client was happy with, during the current crisis.

Reading the to-ing and fro-ing in therapists’ online exchanges, my imagination took me to how it must have been for parents during the Blitz in the second world war. They would have wanted to make things as good as they possibly could be for their kids, even though times were so grim, and the war so close to home.

Maybe a mother would have agonised over whether she should make a cake for her children with the last of the dried egg in the cupboard, or whether should she go round to the neighbour who actually had some eggs from a cousin who keeps chickens, and pay a bit extra for a fresh egg. She cannot do much about the fact that tonight the air raid siren may go off again, as bombers fly over with their deadly load. But she can at least do her best to keep small comforting traditions in the home going on, of baking and providing treats and gestures of love for her family.

Worrying over details such as which platform to use for an online session, in the face of a huge national crisis is, perhaps, in part, a way of distracting ourselves from the enormity of events that we have little control over. But maybe this is also part of us wanting to be sure that we care about our clients in all of this. Even though we cannot individually do much about the supplies on supermarket shelves or the availability of a coronavirus vaccine (we can’t stop the war), we can at least try and work out which is the best way to offer them their sessions online (which kind of egg we should use, to offer those we care for some nourishment).   

Sarah Van Gogh
Before training as a counsellor 20 years ago, Sarah worked in the fields of Theatre-in-Education and community health outreach. She now works in private practice, and is one of the trainers on the counselling diploma at the Re-Vision Centre in London. She also worked for 7 years as a counsellor and trainer at Survivors UK, a service for men who have experienced sexual violation. Her book Helping Male Survivors of Sexual Violation to Recover – Stories From Therapy was published by Jessica Kingsley in 2018. She is the co-editor with Chris Robertson of Transformation in Troubled Times published by TransPersonal Press in 2018. She writes a regular column for the BACP Private Practice Journal.

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