Dark Days, and Bright Spots

I left Milan on February 23, only to be shocked on landing to learn that the COVID pandemic had broken out in Northern Italy. Before long, New York followed suit. Streets like nightmare scapes feature masked ghostlike figures, squeezing to sidewalk edges to avoid one another. Working from home, we adjust boundaries and frames, amidst threat, dread and loss that we share with our patients. We are all in this together, which makes it both harder and easier. The “how are you?” that had served as a perfunctory, rhetorical greeting has taken on a different quality, reflecting deeply concerned, emotional recognition of our joint vulnerability and mutual care. We need each other to be well so that we can survive.

For many of us, this global health catastrophe feels like an extension of the years of trauma that began in November 2016. The sense of shared disbelief, impossibility and unreality of what the US election wrought has intensified with the virus. The health crisis and the Trump

crisis intertwine in many sessions. The pandemic feels like a dream, transforming the heavy residue of three years of desperate peril into an image of the grim reaper himself.

For therapists and patients alike, life goes on in different registers: fear of unemployment and significant financial reversals, death or loss, the chaos of improvising home schooling or child care on the fly—uprooting old habits and patterns, challenging the defenses we’ve always relied upon to get us through.

One patient accepted my offer of a lower fee so she could continue therapy. Another ended our sessions abruptly after contracting a case of COVID and seeing that his business was about to fail. He felt too ashamed to accept my offer to see him for any fee that felt possible until we had some time to consider what had just happened. Although he hopes to return for a “proper termination” once I get back in the office, I wonder if we will continue our work once we are back to our old ways of being together.

The fra