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I have been at my office for four days now and have worked with the majority of my clients by phone or Skype, although a significant number have chosen in-person sessions. We have modified our office setting to make this as safe as possible. I feel somewhat fortunate in that part of my practice for some time now has been on the phone or Skype, so the shock of working “remotely” is softened somewhat. I can well appreciate the adjustments that many have described in their postings here.
Have we been working as usual? Hardly. Session after session is drenched in concern for loved ones, powerlessness, anxiety, and/or paranoid anxieties. I have often felt invaded by the force of these anxieties. We are each and all, as therapists and analysts, faced with the rather daunting task of managing our own anxieties (and in my case, fury) while still being able to listen and engage with the ways in which this chaos and uncertainty impacts each of our patients—and every one will be different. I am exhausted. I am not looking forward to the weeks ahead. But I think these are times (which seem to be occurring with increasing frequency and violence) to be both human beings with our patients and to still maintain the unique and essential reflective distance that grants the space and psychic freedom to each patient to feel and articulate the particular impact of this disruption and vulnerability. This can be a daunting therapeutic challenge. I am most painfully aware of the additional terror for my patients who live in isolation. This I find nearly unbearable.
I have been reminded of two of my patients who during the week of 9/11 saw no need to spend any of their time talking about what happened in the attacks, one of whom said, “That happened in New York; doesn't have anything to do with me,” while the other said, “People die all the time. Does it matter how or when?” Each went on with their usual concerns for their sessions. This was not an easy space to hold,