How many tears did I miss while doing Telehealth?

Wow, what a year! As a psychologist, the 2020 Covid-19 pandemic barrelled through my work, rest, and play, leaving me besieged with questions.

Work

Telehealth equipment including laptop, phone, earphones, tissues.One week I was delivering face to face therapy, the next week I was huddled in my spare bedroom providing telehealth on the phone and through video for 8 weeks. Clients embraced the technology, and therapy continued much the same as it had before, or did it?

Did clients feel safe to talk?

I spoke with clients who were secluded in their cars, curled up in their bedrooms, or who had escaped to a park. We work so hard to make our therapy rooms a place of safety and comfort, and they laid abandoned.  Now I could hear other people in the house, or strangers wandered past as we talked. How were our conversations altered by the lack of confidentiality?

What happened to that space where clients travel to and from therapy?

The coming to and going from therapy is part of the reflective process. You make space and time for yourself, travel there, arrive, settle in, engage in therapy, and then travel away.  What is the impact on the therapeutic process when you just move from the lounge to your bedroom, or when you continue doing chores or parenting while you talk?

How many times did I interrupt the process of therapy?

I would barge in asking “Can you still hear me”? Or ask clients to repeat themselves as I strained hearing only every fourth word on a video call because of that annoying delay. Those spaces of time where no one speaks have a  multitude of meanings in therapy: “I don’t know what to say next”, “I’m overwhelmed”, “I’m angry or sad or tired”,” I’m reflecting and processing”, “It’s too much”, “Stop, “Go on”.  The silences were much harder to navigate on the phone or even by video.

How many tears did I miss?

I learned that the glistening of teary eyes is impossible to see over the phone and difficult over video. How many times did I not pause to honour the tears? How many other emotions did I misinterpret or not notice?

How do I hold space for clients when I am navigating the same storm?

As therapists, we become adept at tracking and managing our own emotions during sessions so that the focus remains on the client. I’ve been aware of an increased need to do this as clients express their fears, grief and anger of living through a pandemic. I could so often say “me too”. I’m continually checking in and asking myself (and clients) “What do I need to do to care for myself today?”

What will work look like in the future?

Clients, friends and family have shared how they loathe or love working from home. Some feel released from the cacophony of noise, people and demands. Others are grieving the loss of human connection.

I cringe when I hear organisations stating how wonderfully productive working-from-home has been and how they will be implementing it for their employees in the future. I’ve heard too many stories of people overworking due to boredom during lockdown or fear of job losses. We are only at the beginning of this forced work-from-home pandemic experiment. What may have been expedient in the initial sprint of the pandemic may not be sustainable in what is turning out to be a marathon. How will friendships develop with reduced work socialisation? How do you build trust in a team when you are rarely in close contact? How many more lonely people will we have in Australia? Will employers make workplaces leaner and meaner and perhaps insist employees work predominantly from home as a cost-cutting move? How can we design better lives for ourselves as we come out of this pandemic?

About 30% of my work continues to be telehealth which is fantastic for clients who, for whatever reason, cannot come in for face-to-face sessions. I am grateful the intensity of delivering telehealth has eased for me and commiserate with colleagues delivering telehealth full time, even though I know some like it. After a day of telehealth, my body was stiff and ached with the increased concentration, my eyes were sore as if I was trying to use them to listen and I was emotionally spent. Do I need to upgrade my computer and earphones or source an ergonomic chair designed for telehealth? Would it make that much of a difference if I did?

Rest

How can we maintain the sanctuary of home?

I’ve vigilantly kept home separate from work, and I like it that way. During my work-from-home period, my haven was temporarily invaded, not just by my work but also by my noisy husband. After 35 years of marriage, I learnt my husband talks a lot at work, much more than I ever imagined! His voice echoed through the house until I banished him to a bedroom. What did others learn about their partners during this enforced episode of closeness? How did others maintain the sanctuary of the home, or was it not important to them? Is delineating between work and rest important? Are people now sleeping and being intimate in their workspaces?

Why didn’t I buy shares in home renovation and craft businesses?

2020 Pandemic Christmas Wreath
2020 Pandemic Christmas Wreath

Before we went into lockdown I encouraged my family to buy what they needed for those small home reno projects and to stock up on art and craft goods. I celebrated rooms painted, pots decorated, furniture made and first-time attempts at embroidery. I received the most beautiful hand made mothers day card. I feasted on new menus. I heard songs broadcast by those who had been too scared to perform.  I learnt to crochet via youtube and created a Pandemic Christmas Wreath. Each year as I hang it I will remember 2020 as the year that was like no other.

As people experience the rhthym, creativity, passion, problem-solving, absorption and satisfaction that art and crafts bring will they be re-valued and retained in our post-pandemic world?  Are art and craft the richest form of mindfulness?

Play

How do I socialise?

For me, play is dominated by spending time with others, particularly those I love. I hold increased gratitude for those who live geographically close to me and to those who have continued to include me in the rhythm of their lives. Friends who meet me regularly for walks help provide a missing structure. I find it unexpectedly difficult to organise meeting up with others. It’s as if spontaneity has seeped out of me. How will I rekindle it? And what about the planners who love to see a full diary, how are they managing?  What are people looking forward to?  It’s as if I’m looking at the world through dirty glasses, something is not quite right yet I can’t wipe it away. How would others describe their experience?

Have communities changed?

Group of neighbours socialising in cul de sac.My Tarragindi neighbours organised regular pandemic drinks in our cul de sac on Sunday afternoons. Initially, we social distanced, calling to each other from across the road. As the pandemic eased in Queensland we became closer.

On ANZAC Day my husband trumpeted The Last Post from our driveway, neighbours joining us from a distance, telling us it was the most moving ANZAC Day they’d attended.

I now know my neighbours far better than I did at the beginning of 2020. Will we continue with these new social traditions? Do communities feel closer now or more distant? Will the way we make and sustain relationships change?

When will I see my family and friends?

My arms ache to hug my daughter, brother, sister, parents-in-law, nephews, nieces and friends. No matter how many video calls we have my most pressing question remains “When will I see my daughter again?”.

Anne Moorhouse, Psychologist

 

Waiting outside the psychiatrist’s office

Getting there

My friend is terrified of lifts so we climbed up the dingy stairwell to the third floor, only to find our exit door locked. After pointlessly pulling at the securely locked door a few times, we turned and scurried back down the stairs, to find the door we’d entered through also locked. Anxiety slowly rose in my throat. What if we’re stuck in the stairwell for eternity?

Empty office corridoor

Frantically, we descended further flinging open the lower ground floor door to the street, bursting out into the bright sunshine. We re-entered the building, now no option remained but to brave the lift. My friend scooted into the back corner, her body firmly pressed against the walls, arms folded against her chest. Her eyes startled with fear and yet also relieved that we were the only ones locked in the confined, windowless space that she hates so much.

The long hallway to the inner city psychiatrist’s office was bland and soulless, terracotta tiled floor, cream walls and mission brown fixtures – a flashback to the ’70s.

Waiting outside the psychiatrist’s office

The psychiatrist, unknown to my friend or me, greeted her warmly, even though we were 10 minutes early.  The psychiatrist had received a myriad of documents and clearly knew that this appointment was going to be distressing for my friend. Despite the kindliness of the psychiatrist, my friend looked pleadingly at me as she slowly followed her to the psychiatrist’s office.  She Continue reading

Uniting Psychologists: Visionaries, Activists, Noisemakers… and Bystanders

A feisty shake-up of psychology

The profession of psychology is undergoing a feisty and invigorating shake-up, triggered by the Medicare Benefits Schedule Taskforce Review into Mental Health. For too long psychologists have trustingly left the management of their profession to the Australian Psychological Society (APS) and the Psychology Board of Australia (PsyBA) which is supported by the Australian Health Practitioner Agency (APHRA). We now realise that these organisations have not advocated proactively for most psychologists, nor for mental health clients, and the result has been a fractured profession. A cohesive mental health service for the Australian community can only be provided through unification.

There are now many more psychologists clamouring to be heard, stimulating hardy debate, challenging untested myths and demanding a united and yet diverse profession to meet the needs of mental health clients in Australia. If you are a psychologist, look at the Australian Association of Psychologists (AAPI) and Reform APS (RAPS) websites and join the Australian Psychologists closed group Facebook page.  These forums have re-ignited my interest in the profession of psychology, dormant for many years, having long ago let my APS membership expire for lack of relevancy.

Uniting psychologists

All psychologists are registered practitioners with APHRA under the general registration standard. A false dichotomy has arisen between psychologists with a clinical endorsement and those without. Those with clinical endorsement have been privileged financially (without any evidence of better outcomes) and are falsely assumed to have greater expertise, knowledge, and education.  In 2018 there were 29,982 registered Psychologists, with only 29% of them having a clinical endorsement. Eighty percent of psychologists are female.

We must celebrate the richness of diversity that different pathways to registration as a psychologist bring to the Continue reading

Dear Mental Health Client, please don’t be too unwell

Dear Mental Health Client,

Mental Health ClientYou came quietly into my counselling room,  looking a bit unsure, eyes cast downwards.  Hesitant to speak.

It had been tough to pluck up the courage and ask your GP for a referral to a psychologist. You hardly ever see your GP and felt uncomfortable when they asked about your mental health and living situation. You gave the GP brief answers, just wanting the appointment over and done with. This stuff so hard to talk about.

Starting your treatment

Mental health clientYou left the GP with a Mental Health Care Plan for 6 sessions, a bit surprised to learn that they’re not free because most psychologists can’t afford to bulk bill. Ouch, this is more expensive than you anticipated. You also learned that you can only have 10 Medicare subsidised sessions each year.  Still, you think, 10 sessions must be enough for the psychologist to “fix” you. Why else would they only give you this many? It seemed like quite a lot of sessions at the time.

It was so hard for you to come to the first appointment. Initially you tell me you are “just a little bit depressed and anxious”. By our fourth session, you’ve trusted me enough to share the Continue reading

Enraged psychologists fighting for an improved mental health system

Enraged psychologistI’ve never met so many enraged psychologists as I have in the last six months. We’re channelling our pent up fury by pounding keyboards, our battle cry is echoing loudly through social media and Members of Parliament (MP’s) are being accosted at every opportunity.

And that goes against everything I know about my usually sedate and contemplative colleagues.

Life of an enraged Psychologist 

Let me tell you a bit about the life of a psychologist. We work with vulnerable people in our Continue reading

Celebrate Stepfathers on Fathers Day

Stefather and child at beach
Photo by Derek Thomson on Unsplash

Let’s take time out to acknowledge and celebrate stepfathers on Fathers Day.  Over 20% of  Australian children live in step or blended families, therefore, thousands of men are stepping into an ambiguous and difficult role.

Those passionate and delightful “in love” feelings couples experience in a new relationship don’t necessarily encompass your new partner’s children. And kids don’t Continue reading

The Psychologist sounds out the Music Therapist

Music Therapist, Claire Stephensen from Press Play Therapy
Music Therapist, Claire Stephensen from Press Play Therapy

At times the rumble of drums or the soft tinkle of ivories floats into my counselling room at Little Window – Counselling, Psychology and Wellness. Then I know that our Music Therapist, Claire Stephensen, is working with a client, and I’m intrigued.  Poking my head into the hallway, I try to see Claire using music in therapy, but her door is firmly closed and the mystery remains.

would not describe myself as a musical person. I sing like a cat on heat, I’m an awkward dancer and my husband used to tell me off for singing Twinkle Twinkle Little Star out of tune to our children. Yet I also know music brings great joy. I hear the first beats of an old love song and memories flood back. My mood can be lifted or lowered through a few well-chosen songs. I know that there is magic in how we respond to music. To satisfy my curiosity about music therapy I had a chat with Claire and asked her a barrage of questions.

Thanks for having me Anne, I know your curiosity is shared with so many people.  I look forward to sharing a glimpse into the ‘music therapy space’.

How do you start a music therapy session?

In music therapy training we learn a lot about the importance of overall structure of a session – the opening, middle and close are each considered to be very important for their own reasons (just like the open, middle and close of a song or piece of music!) – and it will look different for each person I work with. I always intend to meet the person where they’re at – and finish the session closer to where they want to be. For some, this might mean we start with talking before introducing music, and for others, we start with music before we do any talking. Some clients like to start their sessions by bringing a song or piece of music that resonated for them – to help bring language to their current challenges. At other times we talk through the key challenges or wins so we can decide together what the best modality will be for the ‘middle’ part of the session.

So you do talk during music therapy?

Continue reading

“Comparison is the death of joy” and an unhelpful thinking habit

I came across the quote “Comparison is the death of Joy” by Mark Twain the other day and was struck by how succinctly it captured what I frequently hear, and occasionally do. Consider the following ways that joy is killed.

The new mum

Comparison is the death of joy

The new mum gently nestles her beautiful baby boy in her arms. She gazes lovingly at her son, stroking his hair. He’s snuggled in a bunny rug, blissfully milk drunk.  She’s just finished breastfeeding him, happy to do so in front of me.

She dips her head away from my inquiring eyes. “He wakes more at night than my friends baby”. Continue reading

Enjoying a trip to the theatre as an act of self care

Seeing a play is one way that I revitalise myself. For me, a trip to the theatre is an act of self care and pure pleasure. I feel given to, with nothing expected in return. There’s a feeling of connectedness with the actors and the audience which I never get from watching a screen. As a psychologist, I advocate for self-compassion, self care, and connectedness, so it’s important that I walk the talk.  This weekend I indulged myself with two plays.

The Mathematics of Longing

Theatre as self care - The Mathmatics of LongingWatching the Mathematics of Longing at Brisbane’s Le  Boite theatre, I immersed myself in another world for an hour.  I love this smalltheatre in the round. It feels so intimate, and I intensified the experience by sitting in the front row.  A friend insisted that we do this at the last play we enjoyed, and, somewhat reluctantly, I acquiesced. Unexpectedly I discovered that I loved the closeness to the Continue reading

Easing the burden by reaching out

Burden of elephant supported by balloonsClients often experience a wave of relief after their first counselling session.  Their burden is shared and they feel joined on their journey.  That old saying, a worry shared is a worry halved rings true.

Sometimes, you don’t recognise how burdened you’re feeling until the load eases, as I experienced recently.   I’d been working on Ms Forgotten Australian’s biography for over four years and had come to the end of my skills, capability, and motivation. I knew I had to do more but had no idea Continue reading