For the past two months at Birchtree we have all been conducting our sessions through telehealth platforms, relying on Zoom to connect with those whom we see. It has been an interesting and challenging period with understandable ups and downs. The journey through trauma is never easy. The COVID-19 pandemic has tested us all, forcing the world out of their window of tolerance. We have struggled and we have grown – we have had to be innovative to remain connected to each other and to those whom we see. For the first time in my career, we have faced a global challenge that impacts all of us – whichever side of the therapy room you sit in, no one escaped the pandemic without some loss. As therapists, we have had our own therapy and supervision also move remotely – we have a shared lived experience, a collective sense of distancing and isolation, of reaching out through technological mediums.
“Zoom” – the word itself evokes a sense of urgency, a harried rush. The Oxford dictionary defines the verb ‘Zoom’ as “to move or travel very quickly”. How then do we fit this frenetic technology, originally designed for business meetings, with the need for settled, calm and gentle holding – all foundational principles of working with complex trauma. These are thoughts I have been playing with throughout this period of lockdown. Initially thoughts bubbled out of reach, “locked down” inside as we all struggled to adapt to this new way of life. Then, little by little, a narrative formed, consciousness unlocked, mirroring the relaxing of restrictions.
Beginnings and endings are pivotal in attachment relationships – how we settle in together and how we close out these connections. On Zoom we often begin with the clunky sense of seeking each other out – Can we hear each other? Can we see each other? Can we find each other? Occasionally during our time together, we might lose each other through the pitfalls of reliance on online platforms and the heavy load placed on local internet. We scramble to reconnect and find each other again. Finally, at the end, we say goodbye and press the ‘end meeting’ button – aware each time of the seeming abruptness of this gesture for both parties.
I had never before valued so much the importance of transitions – the gentle greeting in the waiting room as we reconnect after time apart, accompanying each other as we walk down the corridor to my room, the ‘settling in’, adjusting cushions for comfort – all rituals that are vital to the structure that scaffolds our time together. It is through these rituals that we can ‘exhale’, letting go of the external world and focusing together on the struggles of the internal landscape. What then when we lose this scaffolding? When the beginning is sudden, and we are thrust into each other’s worlds through the press of a button? Both of us seated in our home environments – transitions lost at either end. Rituals absent, both slightly discombobulated as we endeavour to remain connected.
Similarly, in separating, our usual ritual includes gradually bringing our time together to an end, standing up and accompanying each other back out to the waiting room outside our consulting rooms. There, opportunity is provided to ‘readjust’, with people often visiting the bathrooms to settle and put on their ‘outside face’ as they edge out of their internal world. Instead, on Zoom, endings feel sudden for both parties with the connection seemingly terminated at the touch of the button. Clients are left abandoned in their internal worlds, often still seated slightly shellshocked in their loungerooms. The onus of leaving has shifted – within our rooms it is the client who leaves, walking out into the world outside – via Zoom, however, we exit, “ending the meeting”, leaving them sitting in the same spot, as though frozen on our couch. This sudden separation repeats session after session, understandably having the potential to retraumatize, bringing up past experiences of being repeatedly abandoned by caregivers.
So how then do we rise to the challenge? Now that we can glimpse an end to the need for regular Zoom, as we head towards reintroducing sessions in person, what lessons have we learned? I’m reminded of the tagline from Glennon Doyle’s recent best-selling memoir, ‘Untamed’ – ‘We can do hard things.’ Trauma work is indeed tough – yet we have been reminded that, therapy is concerned with our relationship, not the setting. The pandemic has provided us with a tangible shared goal – that we will stay connected and make it through to the other side. Trauma so often results in rigidity – the pandemic has forced us all into positions of flexible adaptation. Despite the seeming distance, we both stay stable and present. Over time we develop new rituals together. The ‘clunkiness’ of the platform somehow softens. The paradox is that in the disconnection necessitated by the pandemic, we work even harder to connect. We both see more glimpses into each other’s worlds than previously. We welcome pets into the space – ours and yours! Object constancy is challenged – do we exist if you can’t actually “see” us? If the only glimpse of us is through a screen. Hour by hour we show up and you show up – laying down pathways disparate to past experiences. We arrive at a place where we can say, in Winnicottian language, that Zoom is “good enough”. Do I think it rivals face to face connection? No, I don’t – very little does. Yet, we have stayed together, and our therapeutic relationships have survived. New learnings have happened for all of us on both sides of the screen. The pandemic has reminded me of the truth evident in Irvin Yalom’s famous quote: “I prefer to think of my patients and myself as fellow travellers, a term that abolishes distinctions between ‘them’ (the afflicted) and ‘us’ (the healers). … We are all in this together, and there is no therapist and no person immune to the inherent tragedies of existence.”
By Jace Cannon-Brookes
Director and Clinical Psychologist