Depathologizing Psychic Disruption

The van climbs ever higher. I marvel at the spare, rocky landscape and the vast distances on every side as we make our way, curving upward, sometimes perilously close to the edge. Above it all, the Big Sky takes my breath away. Despite the many references I've read and the photos I've seen, I never imagined this experience: its vast enormity as an experience. I am in Wyoming for the first time.

How profound it feels to be thrust into a new world, stunned by its unique beauty, the feel of the air, new fragrances, new animals. I saw a magpie for the first time in Wyoming. Bald eagles flew overhead. What dazzled me most were the light and the wind, and especially the sky that never stopped changing. I could have stood still and watched all day, transfixed. In fact, I had intended to do just that, but the pandemic intruded, and we couldn't stay.

On March 13, 2020—less than a week after I'd arrived—then-president Donald Trump declared the growing COVID-19 epidemic a national emergency. Immediately, schools closed. Social events were canceled. As the virus spread, workers sickened and died. Factories shut down. Shops and restaurants emptied. The elderly were especially vulnerable, and thousands died every day. Then tens of thousands. Then more. Hospitals were overrun; gurneys with perilously ill patients spilled into the hallways, while depleted staff worked around the clock.

That summer, Yale sent a survey seeking mental health professionals who could offer services to members of the community working on those front lines. Nurses, doctors, aides—all hospital staff—were overwhelmed with fear and anger, exhaustion, and unspeakable grief. The survey asked if I had experience working with individuals who suffered from significant anxiety, depression, or trauma. It noted the importance of caretakers taking care of themselves, stating explicitly that it was not inappropriate to seek help from another clinician to secure comfort or rel