Top Five Things I’m Telling My Clients During the Pandemic

What can I say to my clients, who are frightened and upset during this time of upheaval, when I am struggling with the same feelings myself?

This summer I’ve been moving back and forth between my home office and my therapy office. It’s a mile-long walk and I enjoy it in the summer weather. Once a week, I move my clinical notes to my file cabinet at the office and this has given me an opportunity to review my client notes en masse. I noticed some general things I was saying to my clients–they were also things I was saying to myself–which I want to share, in case it’s helpful to you.

I find myself keeping my ear to the ground for what clients report they are doing–those healthy responses to extreme stress that they might not recognize as such–and reflecting that back to them, to remind them of their own resilience.

1.Focus on mindful attention to the body. If you’ve been to any of my recent workshops or webinars, I often tell the story of the 2018 Thai Cave Rescue, when a team of twelve young soccer players and their twenty-five year old coach were trapped by sudden flood waters deep in a cave they were exploring. While they waited for rescuers, the soccer coach, a former monk, taught the team meditation techniques. To manage the physical impact of stress and uncertainty, they focused on slow, steady breathing and keeping their bodies calm. They took control of their nervous systems with conscious intention, which buffered their bodies from the exhausting emotional dysregulation of the fight, flight, or freeze reactions.

An extension of this embodied awareness includes asking clients (and ourselves!) about healthy eating, adequate sleep, and regular exercise. Before I launch into any meaning-making conversation, I want to make sure their body is OK.

2. Our bodies are equipped to survive and heal. While we may feel intense suffering or emotional dysregulation, unable to see the pandemic’s outcome, be reassured: The human autonomic nervous system is built to help us adapt and survive in a dangerous world. Not only can we adapt during times of extreme adversity, but in the aftermath, when the danger’s passed, it also enables us to heal, if we are surrounded by trusting, affirming relationships.

In her most recent book, Deb Dana, LCSW shares The Three R’s of Emotional Self-regulation:

a. Recognize your (or your client’s) autonomic state, whether it’s fight, flight, or freeze or a mix of the three;

b. Respect that these feelings, though extreme and unpleasant, come from an honest, human place. A gift of our human evolution, they are ultimately adaptive and protective.

c. (Co-)Regulate to maintain safety and calm; to settle yourself. Do something to reset your nervous system. Connect with others. Authentic connection is the key to minimizing long-term psychological injury.

The fight, flight, or freeze reaction may make sense in some pandemic circumstances. It’s a crisis after all! In My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies, Resmaa Menakem reminds us: “It’s not that settling is good and activation is bad. Your body needs to be able to do either one, based on the needs in the moment. Ultimately, your body will learn to activate, or settle, or move back and forth between the two as you need to, whenever you need to.”

3. Memory and nostalgia are powerful resources for holding onto ourselves, when our identities feel rattled during a time of tumult. Exploring memories from the past–weddings, births, successes, transitions–can surprise us by their ability to transport us to a different feeling state. Our brains hold these powerful emotional stories in neural nets.

Long before the neuroscience confirmed this truth, there was a famously poignant passage in Viktor Frankl’s Man’s Search for Meaning. An inmate in a concentration camp, a younger Frankl is despairing about “my slow dying” and finds himself, in his imagination, talking to his wife. (He does not actually know whether she is alive.) It’s a moment of gray despondence. “The guard passed by, insulting me,” he writes, “and once again I communed with my beloved. More and more I felt that she was present, that she was with me; I had the feeling that I was able to touch her, able to stretch out my hand and grasp hers. The feeling was very strong: she was there.” Frankl recognizes that his love for his wife is so strong, it endures inside him, a powerful, warm, consoling force that inspires strength and persistence.

Never underestimate the power of becoming lost in a loving memory.

4. Become bigger. In her wise book, Letters to a Young Therapist, psychologist Mary Pipher reminds us that human beings, when faced with extreme adversity, have “a transcendent response.” Even though clients may not be able to see the end of the pandemic, or who they will be when it arrives, they can be reassured, even optimistic, that they will be wiser, transformed, more resilient people with bigger perspectives on the world. This isn’t meant to minimize the toll on our vulnerable clients, or invalidate their suffering in the moment, but to remind us that one role of the therapist is to be hopeful about the long-term possibility of healing and growth.

In a different era, the Jewish mystic Bael Shem Tov writes, “Let me fall if I must fall. The one I will become will catch me.”

5. Creativity is the antidote to destruction. We are living in an environment saturated with a sense of danger and threat. The psychological toll is exhausting. BUT: Have you been noticing friends baking bread? Obsessing in their gardens? Finding their ways back to artistic expression? I’ve been listening for glimmers of my clients’ creativity at home and at work, and then reflecting back to them that these endeavors are strong evidence of their resilience and, in fact, ways that they are healing themselves, as they go, sometimes without even knowing it. I love this now famous passage from feminist writer Wendy MacNaughton, with which I’ll end these notes:

“This is your assignment.

Feel all the things. Feel the hard things. The inexplicable things, the things that make you disavow humanity’s capacity for redemption. Feel all the maddening paradoxes. Feel overwhelmed, crazy. Feel uncertain. Feel angry. Feel afraid. Feel powerless. Feel frozen. And then FOCUS.

Pick up your pen. Pick up your paintbrush. Pick up your damn chin. Put your two calloused hands on the turntables, in the clay, on the strings. Get behind the camera. Look for that pinprick of light. Look for the truth (yes, it is a thing—it still exists.)

Focus on that light. Enlarge it. Reveal the fierce urgency of now. Reveal how shattered we are, how capable of being repaired. But don’t lament the break. Nothing new would be built if things were never broken. A wise man once said: there’s a crack in everything. That’s how the light gets in. Get after that light.

This is your assignment.” 

And it’s not just about ceramics or breaking bread. Doing therapy, being present for people during a difficult time, can also be one of the most creative forms of artistic endeavor.

Thank you for the hard work that you do.

UPCOMING WEBINARS

Critical Incidents: “Debriefing Critical Incidents, Creating Healing Spaces;” November 19-20, 2020; 8:30 am – 3:00 pm each day; 10 CEUs. For more information on why Debriefing Critical Incidents is important, check out this interview with facilitator Andrew Laue, LCSW. 

Clinical Supervision: “Transforming Clinical Supervision: Talking about Race,” January 20-21, 2021; 8:30 am – 12:00 pm each day; 6 CEUs (supervision).

Pandemic Stress: “Boosting Resilience During a Pandemic: Trauma-informed Strategies,” January 28-29,2021; 8:30 am – 12:00 pm each day; 6 CEUs.