The calendar has turned to September, and leaves have begun to change color, but before completely turning my attention to fall, I want to reflect on how strange a summer it’s been. Due to COVID-19, I have had to grapple with more unwanted changes in my psychotherapy practice than ever before. It is best summarized as the summer of “No.” In an attempt to capture the breadth and depth of my experience, I’ve created a list of the Nos that have been hardest for me.

Like what you are reading? For more stimulating stories, thought-provoking articles and new video announcements, sign up for our monthly newsletter.

No break. As a psychotherapist, summer is typically the time of a reduced schedule for me. Between my own vacation plans and those of my patients, I usually have more openings in my schedule. Typically, the warmer weather also decreases the number of new patient inquiries. For those like me who practice in parts of the country where summer sun invites us to be outside, there is less demand for psychotherapy. In contrast, during the summer of 2020, the demand for psychotherapy increased as people tried to cope with the impact of the pandemic. It was hard to say no to those seeking help when the need was so great.

No office. I, like many other therapists, became a front-line responder even as I moved out of my office and online. The scramble to learn Zoom, fashion a home office offering some semblance of professionalism, and establish new protocols with patients I’ve never met in person was a steep learning curve. Questions about HIPPA and collecting co-pays electronically became a common thread on listservs. As I lost the separation between my private and professional domains, my life became limited by lock-downs. The line between working and not-working was blurred. The dreaded commute looked less awful from the rearview mirror of nowhere to go. Six months out, my beloved office has become a very expensive post office box where I go and collect my mail on a weekly basis. Each time I open the door, I feel a bit like Miss Havisham in Great Expectations—the calendar says March, and the magazines are out of date. The water in the cooler is no longer cool or potable, most likely.

No variety. One of the deep satisfactions of my work is the individuality of my patients. The variability of the human experience set against the sameness of my physical space has kept me engaged in my work. But this summer, each session was characterized by universal angst about the pandemic. The particulars were different—the patient who was stuck in an unhappy relationship versus the mother surrounded by bored children—but the plea for reassurance was similar. Even more striking was the lack of separation between my own worries and those of my patients. I suffered from pandemic dreams and changed my routines to avoid falling ill.

No reset button. Every therapist I know complained of feeling burnt out, with little prospect of finding a way back to equilibrium. With gyms closed, travel out of the question, and social activities greatly curtailed, I found it increasingly challenging to practice self-care. As I lost track of the date and the day of the week, it was difficult to determine how to take care of myself. With no museums, movies, or plays, finding ways to let my mind rest and reset took unusual effort.

No way to meet new people. People struggled with the isolation of living alone. Figuring out how to date during the pandemic made dating apps feel even scarier than usual. Women worried about the window of fertility closing without an opportunity either to find a partner or feel safe to get or be pregnant during the pandemic. All of these fears were real, and trying to sort out how to encourage growth for my patients while respecting the reality of living through a pandemic was painful.

No joy. There was so much loss—deaths unattended, weddings canceled, and newborns not held by grandparents. There were no graduations, no proms, and no parties. Summer holidays were scaled back or nonexistent. It was hard work to find the joy in activities that now required masks and social distancing. Four of my patients, however, did get married this summer. After scaling back their plans, in the end, each celebration was a testament to flexibility and changed priorities.

No faith in our leaders. People searched for answers they could trust. Mask or no mask? Six feet apart or ten? Was flying safe or not? The discouragement and at times outrage about the failure of our leaders to lead kept our sessions focused on current news cycles with an abundance of hopelessness.

No more only pretending that Black Lives Matter. Pretending no longer passed as good enough, and although this was a positive change, the challenge was great. The reckoning of how to understand our country’s long, sordid history of racism was dissected within the safety of the therapy relationship. For many of us, especially those of us who are white, the painful and raw experiences of racist feelings and behavior were relatively new to include in our conversations.

No jobs. As patients were furloughed or laid off, economic worries became paramount. Some careers all but disappeared, such as event planners who found themselves not only without a job, but also without a career future. Recent graduates’ dreams of starting a new life were dashed. Older patients felt the sting of ageism in the workforce. For some people, it became a matter of choosing between their jobs and risking their health.

No end in sight. There was no timeframe I could offer for when things would be better. Future plans remained uncertain, and even now there is still no end in sight. Exploring topics of mortality and challenging our very American notions of invincibility and superiority evoked existential crises about the meaning of life. Patients pleaded with me for assurance that things would be all right. Holding out hope, but not false promises, for the future required striking a tenuous balance.

As I and others steel ourselves for the one-two punch of the pandemic and the election this fall, it is worth pausing and acknowledging the toll COVID-19 has taken on our own well-being, not just that of our patients. It has been exhausting. I am committed to find a way to greet the crisp, cooler autumn air and fulfill my professional responsibilities. For despite all the “Nos,” one thing I do know is that human connections are what make life worth living, especially during challenging times like these.

File under: Musings and Reflections, COVID-19 Blogs