With the rise of telehealth and the quick ubiquitous implementation of it, and then the long year that has followed; it might be a good time to pause and consider how your therapeutic container is treating you.
One marked benefit of hosting sessions in your own space is the fluidity with which therapy can exist in the midst of your daily life. Being in your space means being around your preferred creature comforts (including possible “therapy animals”). This shift means skipping the commute to the office, creating possible ease in childcare or work/school scheduling.
There are also noted drawbacks to this technological switch.
Pre-Covid, there was a certain ritualistic bookending on either end of the session that occurred by way of driving or walking to the office, sitting in the waiting room, then traveling to your next destination. There was inherently a moment for reflection and integration. On the front end, preparation time was available- a review of the week, or of existing material. Post-session, there existed a buffer between what came up in session and whatever real-world situation required your immediate attention. If something difficult arose or trauma processing occurred, that time and space enabled a somatic come-down before the stressors of the day reared their incessant heads.
Now, when working over a telehealth platform, it is not uncommon to jump from work into session then back into life mode, and vice versa.
Here are some considerations to create appropriate space and get the most out of your sessions and reclaim the quiet spaces that used to buttress session:
– To prepare for session: Dedicate a space in your home for this time. If possible, make sure not to be backlit, and sit in a comfortable seat. Have a glass of water and blanket within reach. Whenever possible, use this dedicated space for each appointment.
– Ensure you have a sonically private space where there won’t be intrusive noises and no one is within earshot
– Plan for at least 15 minutes prior to the session to prepare. This might look like making some tea, taking a walk, free-writing, or some form of creative expression
– During the session: turn off your self-view. If using a platform that enables the removal of your tiny thumbnail mirror, I suggest it. Not only is it distracting, but it potentially feeds the part of you that might be tempted to ensure you’re doing therapy “right.”
– After the session: instead of closing the computer and heading back into your life of working, emailing, parenting, or erranding— make a conscious choice about what this transitional moment looks like. Can you use another 15-minute pause prior to quotidian demands beckoning?
– Grounding both into session and after the session as a form of aftercare is an integral part of this work. You can enlist your therapist for some specifics here based on what you’re working on
Reflect on what this switch has meant for you— what are you missing from in-person sessions? What is working better for you remotely? The space itself, no matter its iteration, is part of the therapeutic processing—this can be a topic you internally and externally and consciously explore within the therapeutic realm.
What a year it has been for you all. I want to speak to you directly because I feel that the unique ways you have had to adjust to the myriad changes that have occurred this year are often overlooked. I work with college students in my clinical practice, and I want to reassure you that your grief and disappointment are real and justified.
I remember watching the news in the early months of the COVID-19 pandemic and hearing that elderly individuals and college students were most at risk. I was grateful to hear someone acknowledge how difficult this time has been for you all. Not only have you had to pivot to virtual learning and face an increased risk of exposure to COVID-19, but you have been isolated from your friends and social gatherings. With limited access to these social supports, it is expected that you would feel depleted.
In college, your friends are more like family. You live with them, you go to class and study with them, and you share your life with them in ways that were not always possible with your childhood friends. These friendships engender a level of relational intimacy that is seldom replicated during other times in your life. Moreover, you are in a stage of human development wherein you are forming your identity in the context of your relationships with others. This is precisely why it has felt like such an insurmountable task to quarantine apart from your peers and refrain from connecting with them regularly.
You have probably heard many people tell you that college will be “the best four years of your life.” College is certainly a fun and exciting time, but it is not devoid of hardship and adversity. When you feel sad, scared, or lonely, you start to think you are doing something wrong because you are not having the time of your life. The pandemic has added another emotional reaction to this lofty expectation for your college years: anger.
I have heard so many of my clients express how frustrated and devastated they are that they are not having the college experience they always imagined. Please understand that it is normal to feel this way. We are all grieving the loss of our pre-COVID realities, and your “new normal” has been anything but normal. Your old assumptions no longer fit your current circumstances, and accepting this is no small task.
I know how easy it can be to compare your struggles to those of others. People in our community and around the world are suffering. This pandemic has taken loved ones, jobs, and our sense of safety and security. However, you are not immune to the damage it has caused, and your distress is worthy of care and attention.
To quote Brené Brown, “empathy is not finite, and compassion is not a pizza with eight slices. When you practice empathy and compassion with someone, there is not less of these qualities to go around. There is more. Love is the last thing we need to ration in this world. Hurt is hurt, and every time we honor our own struggle and the struggles of others by responding with empathy and compassion, the healing that results affects all of us.”
I want to remind you of how resilient you are. You forged your own path by going to college and building a life apart from your family. This requires courage, and doing so amidst a global pandemic has tested you in ways you never thought possible. I challenge you to practice self-compassion by treating yourself how you would treat someone you love. You are weathering this pandemic the best you can, and your best is always enough.
As we approach this harrowing year-long anniversary of the pandemic, or at least of the collective awareness and general quarantine period of it, it feels important to honor thehorrorwe have witnessed. You might be experiencing the pandemic personally via loss of a loved one, shifting or lost work, social isolation, or perhaps your role has been more of a distant observer, or even seeing it through the lens of survivor’s guilt. Regardless of role or impact, we are currently living inside of an ongoing, slow-rolling, ever-unfolding collective trauma. Using imaginal tools can create some underworld and overworld understanding that is digestible while making personal meaning of this era. While many possible gifts have emerged, of note: the reconsideration of our shrine dedicated to “busy,” and a questioning of our ever-quickening pace; it is fair to say we are living in terrible times. Both Joseph Campbell and T.S. Eliot noted the world as a possible “wasteland,” yet used narrative and imaginal tools as a framework to withstand and even deepen psychological capacity. Campbell duly noted that by using myth we can vitalize ourselves, thereby creating vitality in the world around us (1988).
While there is medicine in creating a “normal” routine and buoyancy where possible, I wonder from a depth psychotherapeutic perspective, how healing it might be for us to incorporate the horror of this time more intentionally. This honors any upset and makes room for collective and personal grieving. Using the tools of the imagination is one way to incorporate the discomforting parts of the pandemic, both personally and clinically. Imagination can be used to meditate horror, or our reaction to horror, which is generally fear. Or it might be channeled to imagine and incorporate alternate endings, thus promoting hope. Equally, it can enable a deeper, storied processing of the events.
Trauma and Imaginal Healing
We know that trauma interrupts critical pathways in the brain that can impact, among many other things, the region that regulates negative emotionality. Through James Hollis’ analytic work and research in Houston, expressive arts were seen to “reactivate those portions of the brain and reinstate growth” (2000, p.9). Donald Kalsched, largely known in the depth psychoanalytic and trauma field, has cohered that the imagination “helps us integrate body and mind, affect and image, conscious and unconscious” (2020). And image is naturally the way we witness fantasy, creativity, and make meaning of the day-to-day world we encounter as a conscious species.
“There is a mystery about this which stimulates the imagination; where there is no imagination there is no horror.”
– Sir Arthur Conon Doyle
Children teach us that holding space for the horrific can be healing and normalizing. Ask a young child to tell a story and many will quickly turn to the grotesque or the monstrous. They may even laugh while recalling a grim story from a book, or poke with curiosity about a character that gives them nightmares. Before defenses get installed into their hard-drive, so to speak, children are mostly comfortable with shadow-incorporation. Imaginal work offers a relatable, archetypal path to feel into what is dark, as a way to integrate wholeness into our psyches.
Why Honor the Imagination?
Before there was language, there was image and story. We have evidence of this, for one, in archaic cave paintings. It is encoded in our brains to storytell, and recognize patterns of story. We are narrative beings, and images are some of the ways our psyches take in and experience information. We speak in symbol. Our dreams speak in symbol.
At times, especially in times of grief, language can feel limited. Even our common sayings point to this: there are no words, I am speechless, etc.
In the trauma world, often images are used to first encounter how something may have gotten storied in the psyche. Making use of the imagination which can coalesce and transmute images, somatic sensations, emotions, the ineffable– is a comprehensive way to “meet” what is showing up.
Imagination is more important than information
Honoring imagination enables us to tap into our own narrative or the stream of archetypal patterns from the collective unconscious. In this primordial stream, we can encounter recognizable archetypes, or patterns of behaviors, alongside images that might resonate. As a meaning-making species, it can be healing to know that we are familied and recognized in other stories that exist outside of our own heads. We already, perhaps unknowingly, are in contact with archetypes, explored through film, books, video games, and Greek myths. Even our social media platforms respect the human propensity to narrativize as a way to connect, through Stories.
Using fairytales as an example of this work; you might immediately recall a tale that was once treasured as a child. This is one way we can tap into original stories from early life that carry personal meaning. In a fairytale, it is easy to encounter internal or external characters or motifs that resonate with life, relationships, or difficult situations. As Sabrina Orah Mark said recently in The Paris Review: “The reason why fairy tales exist and thrive is because our bodies recognize them like they are our own. Our same blood type. Because we recognize wolf, witch, forest, kiss, curse, spell, mother, the stories latch” (2020). Mark is noting that the stories “latch” because they are archetypal in form and as ancient as humanity. They carry patterns and a common language of relating to, or of rejection, or of horror, pain, beauty, protection.
What Does Working Imaginally mean?
Working imaginally is flexible and spontaneous. Engaging with inner figures, with archetypal characters within and through myth, narrative, fairytale, etc, is vivifying. For some clinicians, it might mean play therapy, unstructured play, or sand tray. For others, expressive arts techniques are used. Narrative and drama therapies can assist in tapping into image. With depth psychotherapeutic training and a trauma-focus, I tend to use the tools of fairytale analysis, expressive arts, dreamwork, and classical Jungian sandplay as clinical tools.
Meanwhile, I invite you to honor your original images by revisiting your favorite fairytale from youth during this pandemic anniversary. Sit down, really sink into the tale and notice what comes up.