Stephen, Psychotherapist, San Francisco
By Wil Williams
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Stephen is a psychotherapist based in San Francisco. This is his story.
How has your work as a therapist changed since the outbreak started?
It’s been pretty dramatic. The most significant way is that I’m seeing almost all of my patients virtually or remotely — on the phone, FaceTime, Zoom. While that’s something I do on a smaller scale with certain patients, it’s never been something that I’ve done with everybody. I actually am continuing to see a handful of patients in my office who, for various clinical reasons, are so isolated or anxious or struggling in a particular way that it makes more sense to try to hold to some normalcy.
Everybody, every session, is being affected by this pandemic in such profound ways. There isn’t one session I’m having where there isn’t terror of contracting the virus through their spouses or because they’re a physician on the frontline, etc. Sessions have had to be rescheduled or canceled because suddenly a parent is homeschooling their three kids, or what have you.
Not since 9/11 has there been such a galvanizing and pervasive tsunami of dread and terror that everyone is feeling and experiencing in real time, at the same time. It’s very intense.
How has that shaped your perspective on the pandemic?
We’re all in it together. This isn’t something that people are bringing in that I can just relate to or empathize with. This is something that we’re all living through together.
How has this shared experience affected your day-to-day operations at work?
There’s a real paradox, actually, in all of this remote and virtual work. There’s a very unique kind of closeness that feels like it’s breaking through the screen. I think that is, in part, due to the fact that we’re all going through this crisis together. Some defense feels like it’s being upended or suspended. People seem to be willing to show up in different ways. The old rules pre-COVID are being tossed out in a certain way.
One of my patients who feels very strongly that they want to continue to see me in the flesh, who usually walks to my office Friday mornings, is still walking, and I’m walking to meet him in the park a block away from my office. Now we’re doing walking sessions, five or six feet apart. It’s nothing short of revolutionary. It sounds simple — the whole structure of our work is the same — but now we’re out in the park briskly walking. It brings a different kind of connection and sense of solidarity as humans, as fellow travelers, to the experience of being together. I don’t know if we would have come to this without being confronted with this pandemic.
How was the decision made to still see some patients in the flesh?
There’s a part of me that feels very self-conscious [about that choice]. It’s a strange phenomenon, even as I’ve spoken with certain colleagues who have been strictly homebound, not seeing anyone face-to-face. There’s almost something taboo about it at this point, like I’m doing something wrong. But I feel like the decision is something evolving; it’s a process that’s organic. I don’t think I’ve made a decision.
I have been very carefully working through my own ethical responsibilities, both to my patients and to being a responsible global and local citizen. Just as medical doctors are at the frontlines risking their well-being and tending to the immediate physical needs of the population, mental health clinicians are first responders to the emotional crisis of the population. For me, I felt like I need to show up. I need to come to my office and be safe and disinfect and sterilize and keep a physical distance (which, of course, is the case anyway). For a few patients, I needed to give them at least the opportunity to come in if they chose to. And it’s scary. It isn’t without risk. It’s tricky.
