In This Pandemic, I Miss the Refuge of My Therapist's Office

Why teletherapy isn't quite the same.

Posted Oct 26, 2020

 Mangostar/Shutterstock
Source: Mangostar/Shutterstock

I drove by my therapist's office today. It's not so unusual. The stucco building with the blacktopped-path leading from the sidewalk to the windowed front entrance sits on a busy road I travel almost daily. But today, as I approached, I felt an instinctual pull to click my blinker and turn in. For an instant, I considered it. Common sense prevailed, though, and I kept moving with the traffic, the structure shrinking in my rearview mirror.

Unexpected yearning threaded into my chest, and tears burned my eyes. Silly, I chided myself. It's just a building; he's not even there. I pictured Dr. B at that moment, sitting at his home office desk, leaning back in his blue chair, peering intently into his laptop, the cluttered shelves of varying heights that line the far wall creating the backdrop to frame his head and torso for whichever client was on the other side of his screen. In a few hours, I would be that client, logging into the "waiting room" of the HIPAA-compliant virtual platform that, in the seven months since Covid-19 shuttered businesses and mandated social distancing protocols, has served as his alternative counseling space.

I still haven’t adjusted.

I am genuinely grateful that Dr. B has an alternative counseling space to connect with his clients during this pandemic and that he's been available to talk me through the many, many moments of angst about this new and uncertain way of life, but it's just not the same.

Eight years ago, I started having panic attacks. Episodes that began seemingly out of nowhere—most often when I was alone in my car—my heart hammering against my chest, the blood thrumming in my ears, my breathing shallow and sharp, an uncontrollable shaking traveling up and down my limbs, my whole body immobilized by a fear that felt boundary-less. Convinced I was losing my footing, and possibly my mind, I sought mental health counseling.

The first time I sat in Dr. B's office to address the panic problem, I'd felt the unease and vulnerability of the moment so acutely that, within minutes, I'd dissolved into an incoherent heap of emotion—complete with mascara-blackened tears tracing ugly rivers down my face—as the lid on the container storing my hardest memories just let go and a cascade of unresolved grief spilled everywhere. Even then, despite the intensity of my discomfort and long before I really trusted the whole process, I sensed something singular about that space meant for truth-telling. That my mess was okay. That Dr. B did not have a carry-in, carry-out rule expecting me to clean up after myself and take my trash with me when I left. That there was room there for what had spilled to stay until I was ready to return and look at it again.

Since then, Dr. B's small office has become my own sacred landfill. The faithful place I go to dump the things that muddle my day-to-day life and feel too weighty to manage. I've gratefully deposited piles of sadness, confusion, anger, fear, disappointment, and pain into that space. I've unpacked countless boxes pulled from my mental storage unit, sorted through their contents, and let go of the items that are no longer useful for me to hold onto. And I've released an ocean's worth of tears there because nowhere else in my world feels quite so safe to be quite so vulnerable.

The transition to teletherapy has taken this refuge, and with it, the separation that I desperately need from my messy emotions. Now, when I sit down for my weekly 50-minute session with Dr. B, I don't get to escape to the sanctuary that's meant for just me, and all of my complicated feelings. Instead, I have to find a spot somewhere in my house where I'll avoid being interrupted or overheard by my husband and children who are working and schooling from home now, too. That I'm in therapy is no secret, but knowing that anything I say is only between Dr. B and me has always been a conduit for greater honesty.

When the pandemic began, I tried leaving the house, sitting in my car in a parking lot, and logging in with my phone. Poor connectivity—leading to multiple instances of either me or Dr. B freezing on the screen or being booted off the platform completely—and a disquieting sense of being watched through the car's windows, put a quick end to that approach. I've opted instead for my guest room with the door closed and earbuds in to, at the very least, keep Dr. B's words just for me. 

There, I open my laptop, the same laptop I use to access the platforms that store all of the teaching materials for my college classes, the same laptop I stare into for hours as I revise my memoir manuscript—the hard story that is responsible for so much of the emotional residue I've had to scrape off in therapy. The laptop that serves basically like a close coworker. I open that laptop and log in to Dr. B's page on the teletherapy website. In the minutes before he connects, I stare at my image staring back at me on the screen. I am hyper-aware of my appearance and the lighting and my own backdrop.

I wonder if I'm visible to Dr. B even if he's not visible to me, and I try to seem casual and composed. By the time the screen fills with Dr. B's kind face, relegating my live image to a small square in the right-hand corner, I am completely self-conscious. But unlike when I transition from Dr. B's actual waiting room and settle into my position on the center cushion of his brown leather couch in the shelter of his office, relaxing into the familiarity of the space, drowning out all other sounds except the steady rhythm of the traffic beyond his window, in the online format, I can't shed that self-consciousness. It digs in, infecting me with all of its sabotaging questions.

What else, besides my problems, could grab Dr. B's attention? There's a window over his desk—I know because once a fire truck screamed by, and he was naturally distracted by the curiosity of its destination. Since we no longer share the same space, I can't see the things beyond the borders of his screen that might pull his gaze away from me. What happens if there's always something out there that's more interesting than I am?

Where, in his house design, is this home office, and how distant (or close) are we to the rooms where his wife and children are going about their days? I sometimes hear the barks and whines of his 8-month-old golden retriever puppy from somewhere past what is visible. Do my words filter through the computer's speakers and leak into those areas? Am I unintentionally disrupting the order and sanctity of his domestic space with my unmanageable stuff?

These questions and the fears at their edges are getting in the way of my therapy. Our sessions hold echoes of the early days of our work together before we'd established a firm foundation of trust that made me willing to show him the uncomfortable debris of my past experiences. These days, I am, once again, the performer on stage, always wary of my audience's scrutiny.

I fully recognize that "Performative Me" is counter-productive to the actual purposes of my therapy:

  1. To stop caring so much about what other people think of me
  2. To learn to live more authentically,

To cope with the debilitating anxiety that often accompanies my attempts at numbers 1 and 2.
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But much like the self-consciousness, this persona is not easy to shed. She's all about keeping things neat and tidy in cyberspace. She represents my particular neuroses, and I don't blame Dr. B for her presence. Like countless others in this year of impossible disruption, he's doing the best he can to navigate our "new normal." I'm trying to adapt, too, and maybe I eventually will. But right now, without the safe haven of my physical therapeutic space, therapy no longer feels like a safe haven. 

Pre-pandemic, I used to joke after particularly hard sessions that I'd like to live in Dr. B's office. The comfort that layered over my pain in that space, combined with his reassuring presence, cocooned me in a way I couldn't recreate beyond those four walls. "I'll be really quiet," I'd say. "You'll hardly know I'm here." In the same vein, I'd talk about what the end of our therapeutic journey might look like. "You'll have to kick me out or retire," I'd laugh. "I'm in it for the long haul." On the other side of the jokes was my need to lay claim to this place that had collected so many pieces of my story. To own my embodiment of that space. To come and go on my terms. Covid-19 forced me to vacate too soon. Maybe it's the loss of agency inherent in that departure that I really grieve.         

I often give my writing students a prompt from author Georgia Heard's book, Writing Toward Home. She introduces the Spanish word querencia—"a place where one feels safe, a place from which one’s strength of character is drawn, a place where one feels at home." I ask my students to describe the places where they feel most at home. Ironically, these descriptions rarely portray their actual houses. They depict beaches and mountains and forested spaces, crowded city streets, bustling coffee shops; sometimes they don't describe locations at all, but instead the feeling of being in the company of a particular person. 

I can't help but think about those spaces, too, and how our restricted access to them and to each other is folded into the cumulative experience of loss during this pandemic. It's not just my therapist's office that has been dispatched to a zone limited to two dimensions. Meeting with people in the practices of my everyday life—college classrooms, businesses, church, even family gatherings (because mine resides across a closed Canadian border)—has taken a mostly virtual turn. The normative ways we interact and build on relationships by "being in the world" together have been suspended.

We are all grieving our loss of agency over how and when we enter the sacred spaces of our lives, renegotiating what intimacy feels like and redefining our parameters of trust. It may take some time for us to learn how to embody and feel sheltered in the virtual platforms, too. It may also mean reclaiming our ownership and attempting to inhabit those platforms in more authentic ways. As a first step, I've just read this essay to Dr. B, and maybe that's a way to start.  

References

Heard, G. (1995). Writing Toward Home. Portsmouth, NH: Heinemann.