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