We Are the Canaries in the Mental Health Mineshaft

Psychotherapists, you are the early warning system for pandemic fumes.

Posted Apr 06, 2020

© 2020 C. Malchiodi PhD
Pandemic Diary: Physically Distancing Canaries in the Mineshaft," Cathy Malchiodi, PhD, 04.06.2020
Source: © 2020 C. Malchiodi PhD

Lately, like many of my psychotherapy colleagues, the turbulent air currents of this pandemic are now firmly embedded in my life narrative. I lost a relative in Italy during the first few weeks of the coronavirus outbreak amid my own nightmares of people I love being put on a ventilator, dying alone in a hospital bed and quickly cremated and buried without ceremony or preferred ritual. These moments were intensified by simultaneous worry about two friends who ended up in the hospital because of tenacious symptoms from the coronavirus.

I know I am not the only one with these stories. They are becoming all too common at this juncture of this global crisis. And I am keenly aware that these stories may only be floating on the surface of a tsunami of mental health issues about to emerge.

Like many psychotherapists, the individuals who make up my professional social network form another significant narrative thread for me. As the situation in the US and around the world turned quickly toward mitigation after unsuccessful containment, the majority of my colleagues were told to transform their case loads into telehealth sessions over the span of a few days. Initially, I watched with awe at how these individuals enthusiastically embraced the new terrain for teletherapy to their existing clients. They also extended their services to those who were now told to “shelter at home,” faced with the disorienting experience of social isolation. I have also been impressed that webinars demonstrating how to conduct online sessions on Doxy.me and Zoom popped up on social media and in my e-mail box like so many spring weeds. Among my expressive arts and play therapy colleagues, literally hundreds of activities to offer children, adults, and families via computer proliferated on Facebook and Instagram. 

I have seen each of these very dedicated individuals begin to run at the pace of a sprint when what is upon us requires the attitude of a well-paced marathon runner. Now this narrative has entered another distinct phase—a noticeable breakdown among even the most stable of my colleagues. A fatigue is already settling in from that initial rush to be a competent “telehealth professional” during what is a complicated, multi-layered trauma narrative that spans every part of daily life. Some have retreated to their brains, working tirelessly on blogs and YouTube to not only help others, but also in an attempt to contain their own distress. Many in my professional circle are pulling back from communication rather than follow their own well-worn advice to be sure to “reach out to others to support your own mental health” on a regular basis. Some have shut down connection completely; the experience of feeling has become untenable for many on most days. 

In fact, during the first week of the migration to digital platforms for telehealth services I witnessed one colleague begin to emotionally unravel before my eyes. The evaporation of a routine of going to a workplace each day, engaging in a busy schedule of seeing individuals for therapy, and interactions with workmates was just too much and all too fast to make the adjustment. Using a screen to communicate with a case load of children and families took away what was the most enjoyable part of the work—to be in the same space with other humans in all its messy dimensions. Prosody, body language, gesture, proximity, visual impact, and all forms of sensorium, all suddenly gone. 

It was a matter of days until my colleague had to take a leave from the clinic and is now in the slow process of recovery from the unrealistic demands that have been placed upon all mental health professionals in the early days of the pandemic. To me, this individual represents the “canary in the mineshaft” and is the early warning that many of us are entering a danger zone when it comes to maintaining the emotional stability necessary to weather what’s ahead. Much like the coronavirus, we therapists will display a continuum of responses. Some of us may be seemingly asymptomatic, maintaining an even strain, but a little bit unwell just under surface. Others will struggle with loss and radical change as well as loneliness and fear, dominant narratives of this particular mass trauma. 

Truth be told, I consciously chose not to jump into the fray when this pandemic began to show the first indications that mass trauma was upon us. I have not taken on extra cases in my practice for the moment because I know I have my emotional limits right now. As an educator and author, I have been withholding the need to rehash lists of tried-and-true remedies for traumatic stress or develop more charts and graphics about how to negotiate this rapidly shifting situation. But I know that I am still in the early stages of awakening to what we are all experiencing, personally and collectively. It is, in fact, humbling to be at this juncture, to have to let go of previous expertise and expectations to know the answers. 

Right now I am allowing myself to be in free fall about what I thought I knew about traumatic stress. In doing so, I am beginning to rediscover my own emotional equilibrium, as imperfect as that may be. And I am finding a new rhythm, the subject of my next post and what I have come to believe is one possible answer to stabilization in this Strange New World.