Your Therapist Is Online

Teletherapy is different but can it still be helpful?

Posted May 11, 2020

Photo by Paige Cody on Unsplash
Source: Photo by Paige Cody on Unsplash

If there's anything we've learned in the past month or two of this pandemic, is that life can be unpredictable and full of twists and turns. What was normal and familiar yesterday feels unimaginably alien today.

We have learned to transform our lives entirely in what looks like really such a short amount of time. We have learned to make our homes into mini-offices, do all meetings online, home-school our kids, cook, clean, and take care of our homes, selves, and others simultaneously. We have learned to live without the touch, hug, smile, kiss, and warmth of people we may love in our day to day lives.  We have learned to prioritize safety over comfort, reassurance, and longing. And in the depths of our despair, we have had to let go of family members and friends whom we were unable to hold and caress in our good-byes.

And we are still reckoning with an uncertain future in the days to come. Our mental or emotional state, financial uncertainty, and what the new normal will be.

It's no wonder that as we deal with the ramifications of the pandemic on our lives, we have learned to adjust and be flexible with how we receive care. This includes our perception of both telehealth and teletherapy. Previously hesitant clients and providers have come to understand online sessions as an important way of receiving support, guidance, feedback, and wisdom during these turbulent and troubling times.

When I first dabbled with online therapy, I wondered if I would be able to keep pace with in-person sessions. So much is learned and communicated in those simple moments of walking in, shaking hands, greeting one another, sitting face to face, and talking about life's troubles. Would I miss the familiarity of the schedule and the anticipation of a visit? The catching up, the keeping track, the familiar rhythms, the prosody, the unsaid.

And as I (somewhat) reluctantly switched over entirely to online sessions, I contemplated what the change would look like and feel like. What would I catch, be curious about, or miss, or feel left out of? How would I learn to do the dance of therapy online with my clients? Would they be able to hold the step, be willing to learn, improvise, and continue to learn, and benefit from our work together?

It feels prudent to share some of these learnings with others who may feel similarly confused or uncertain of the benefits. The anxiety they experience while grappling with whether it can work, and help them in the way that the old model did (in-person sessions). I believe it can with a few modifications in the way we approach sessions on the screen, which I am listing below:

1. Having things to talk about and bringing those issues to sessions

Doing online work somehow can feel most helpful if we do our work in figuring out what would be helpful to talk about. Because we often show up quickly to online sessions, we may not have the luxury of travel time to think this over. Use your free time (in the shower or break) to jot down a few quick things on your mind that would be useful to discuss with your therapist. Write this down if possible and keep a journal. This helps you track what you have covered and what remains to be addressed. 

2. Silence online is okay too

Although we may be used to silence in person, online it can sometimes feel awkward or odd. The moments of just basking in the gaze of your therapist may now feel like a colossal waste of time. But I guarantee you it's not. Not every minute or second does a thought, feeling, or experience need to be verbalized for the experience to be productive. Moreover, we all need time to think, reflect, introspect, make connections. It's important to not think of online therapy sessions like a business meeting. If there's silence or pause, learn to use it as a means to move off-stage for a bit. Re-focus, re-center, and let go of the pressure to jump in.

3. Take the skeletons out of the closet (finally)

This may be the best time to verbalize that which may have been left out before. The luxury of time has allowed us to reflect on what still needs work, what may have been shared, or left out (intentionally or unintentionally) in session. I have seen clients open up and talk more about their sex life, infidelities, insecurities, disruptive marital, and familial relationships than ever before. Sometimes, we have no place to run or hide, and neither do we have the distractions that previously kept us in places we didn't need to be.

4. Seeing a different side 

Doing sessions online has meant experiencing and seeing each other in a different way. I've seen homes, pets, significant others, bedrooms, kids, office spaces, artwork, special interests, and hobbies, cars, and bathrooms. My clients, in turn, have seen me struggle with technology.

The advantage here has been also seeing people who are vulnerable, raw, more open, more reflective, and less distant. I've heard them playing musical instruments, show me their gardens, give me a tour of their kitchen or apartment and introduce me to their pets, spouses, and children. These are special experiences that I don't always have the ability to partake in when I'm in my office and I'm glad for them.

It's not very often that we find ourselves in the midst of common pain and suffering, albeit it looks different for everyone. When experiences help us have a better sense of the person on the other side and see the humanity in the experience, therapy no longer feels like a career or profession. It feels like a privilege. Despite the qualifications, degrees, perceived power differentials, unbalanced levels of self-disclosure, here we are. Two people in front of a screen, living a similar shared experience of being home-bound, trying to figure it out, and doing our best to learn, grow, and adjust to changing times and expectations. After all, one of the best gifts a therapist can pass onto a client is flexibility in mindset, and approach by embodying it themselves.