A long, long time ago I was a child, then years later psychologist, mother, and now a candidate who has spent my whole professional life working with children and their parents. Then and now, I have loved fairy tales and bedtime stories. One recent, beautifully done video, a tale I found particularly comforting and strongly urge you to watch on YouTube is called “The Great Realisation.” It takes place in the future. A father tells a bedtime story to his young son about the impact of the coronavirus on the world.
Before the virus, the world was lonely, wasteful, and dirty. Our values had taken a turn for the worse. Money, technology, buildings, and politics ruled. But then the virus arrived, and we had to hide. Amidst the fears, the “people dusted off their instincts” and “smiled.” Simple pastimes like dancing, singing, and baking together returned, enabling more meaningful interactions. We developed renewed respect for our environment and the earth began to breathe. Once a cure was found and we ventured back outside, we brought with us what we found rather than what we lost. The child asks why it took a virus to bring people together, and his father replies sometimes one has to be sick before they start to feel better. “Hindsight is 2020.”
And now our tale:
Once upon a time in the winter of 2020, a new virus invaded the world, taking control, and threatening our lives, safety, and financial security. Our normal everyday lives were upended, disrupting our predictable routines, structures, and comforts. Everything closed. We were forced to quarantine, isolate, and work from home. We were literally dangerous to each other, potential attackers and enemies in a Kleinian, paranoid-schizoid world externalized in real time with one exception: It was all real. Loss was everywhere as we were forced to hide from the omnipotent Covid-19. And to worsen matters, we lacked effective leadership to calm the panic and reassure. Left to find our own epidemiological experts and authority, we relied on social media, TV, and newspapers to guide us through potentially traumatizing times in systematic ways. In effect, we were abandoned by our parental figures and forced to fend for ourselves through the chaos and terror.
The following is a collective sharing of candidate reflections, including my own, on our psychoanalytic training and lives at this time, as impacted by the pandemic.
Almost at once, across the country, classes, supervision, control cases, and candidates' own analyses went remote, conducted from the safety of homes. In many ways, it was fortunate training and work could continue in these novel ways. But there were losses. There was a shared sense of being torn from the support and camaraderie of candidates' programs as daily or weekly treks to institutes halted. No more chatting with the administrator, searching for snacks in the kitchen, running into other candidates, analysts, friends. No more evenings, sitting around a table discussing ego psychology, object relations, Winnicott, Loewald, Bion, technique, case conferences. No more in-person learning over a meal together. some candidate classes felt like family, so there was grief over ending training without graduation ceremonies to celebrate completion. As one candidate remarked, “I can't hug my colleagues at the end.”
For others, in distance-training all along, the experience changed less. These candidates, typically using phones not screens, were ahead of the game. With their analytic cases, they had become accustomed to focusing on breathing, pauses, silences, without facial expressions as cues.
There seems to have been mixed results among candidate cohorts in transitioning to online control analyses. Control cases that were disrupted, control cases when analysands found the physical absence of their analyst hard to bear, felt like “devastating losses.” Some control cases were delayed until the pandemic was over, thus delaying candidates' training. Some candidates, whose cases transitioned to telehealth, reported feeling frustrated with the lack of embodiment in their sessions. A two-dimensional video representation made it difficult to read nonverbal reactions, body movements, and facial expressions. Poor internet connections, glitches, freezing, and audio problems complicated an already interrupted situation.
One candidate described a patient, primitively organized before the pandemic, who became psychotic when the analysis went remote, as their internal world collapsed in response to a dangerous external world. For candidates doing play therapy with children, it was not only the loss of the in-person analyst but also the medium (play) through which
Sheryl Silverstein, PhD, an advanced candidate in the adult and child tracks at the Western New England Institute for Psychoanalysis in New Haven, maintains a private practice, and is on the clinical faculty at Yale School of Medicine, Psychiatry Department.
they communicated that felt particularly challenging. With cases that continued online, there was loss – of the physical presence of both and the familiar going-on–being within the comfort of analysts' offices and playrooms. When control cases were terminated, the sense of loss was magnified because there wasn't the opportunity to say goodbye in person. As one candidate said, “We both suffered the loss of not seeing each other one last time, having weathered years of work together, and arriving at an end where we can look at each other and say goodbye.”
A few candidates expressed guilt that they felt good, lucky while others faced sickness and death, including health care workers on the front lines. Those living in New York City grew accustomed to the wail of ambulance sirens. Candidates working in clinics or agencies experienced more tragically virus related deaths. Some left the city to stay for extended periods of time with relatives or in their vacation homes in other states.
While there was anxiety around beginning online analyses, starting intensive in-depth treatment remotely and uncertainty that cases will continue online once it is safe to return to offices, the move to remote analyses wasn't all negative. A candidate expressed gratitude and humility that the analytic process and therapeutic relationships weathered the transition to online work. The depth of the analytic process was credited for that resilience.
For many, there were silver linings amid illness, fears, and uncertainty. The pace slowed. There was no commuting or traveling, which allowed for more time with families and pets. Older children came home. It was almost like an extended snow day— an unanticipated stretch of time with less pressure to tend to the usual errands and more permission to binge on movies and TV shows. Old fashioned pastimes like board games and puzzles returned.
As we know, there is no “happily ever after” here. Questions about returning to our classes, supervision, and offices hover on the horizon. Anxieties about whether we or our patients carry the virus, to infect each other, contaminate our couches, spread illness to other patients impinge upon the analytic process. Questions arise as to what format classes and supervision will take. However, in “The Great Realisation,” transformation is the theme; perhaps so too here along with hope. We as a profession are in the throes of change, as we experience and accept, with open curiosity, online analyses as different, but valid and real. APsaA created venues that seemed inclusive and responsive; zoom peer consultation groups and candidate Town Halls. These online “remote” events brought us together from all over
the country in a safe space to discuss psychoanalytic ideas. Like in the video, out of crisis and chaos comes growth and, in our tale, perhaps a different vision for psychoanalysis. Candidates are the future for this field and perhaps we can take with us our own great realizations from the pandemic and its disruptions, and improve and expand upon the ways psychoanalysis is applied, taught, and understood.