The Healers: Therapy in the Time of a Pandemic By Jeffrey Chernin, PhD on 4/13/20 - 3:37 PM

We are therapists. We’re the healers, the modern-day shamans who have taken millions of people on heroic journeys of self-discovery. We have treated the wounds of countless individuals, couples and families, and have provided invaluable assistance for people to lead better lives, love themselves more and become the best versions of themselves.

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

And now, due to COVID-19, we’re seeing something new. Beneath the rubble of our seemingly collapsing culture, we are also simultaneously seeing an increase in introspection, self-reflection and the very pace of therapeutic movement. Before I discuss these hidden opportunities of the pandemic, I’d like to mention a phenomenon that I’m seeing among therapists and patients: We are all along a non-linear spectrum in relation to the impact of the coronavirus. Here are the phases I have noticed:

· Shock, with a big dose of despair and incredulity
· Panic – hoarding and fear of becoming ill and dying
· Dealing with fundamentals and the Big Adjustment

Where do we shop? At the store, online?
How to set up the home office? The home school?
How do we re-divide chores?

· Settling in – it takes weeks to establish the new normal
· Questioning our values, choices (including our spouses), and behavior
· Seeing the opportunities for growth, maturity and change

In the recent past, I have seen couples talk about important, formerly ignored issues. They are aligning their priorities and seeing the bigger picture, overlooking “the socks on the floor” naggings and replacing them with gratitude and a greater generosity of spirit toward one another.

Couples with children are eating dinner together, in some cases for the first time in years. I asked one couple, who is walking more, to each take one of their two children on walks. I suggested: Get to know them better and give them the opportunity to know you. Tap into your strength by giving them guidance but acknowledging your own fears and concerns. Attune to them by validating their feelings – whether that it’s a good thing for mommy or daddy to be home more often or the terror at the thought of what might happen to them.

In my work with individuals, I’m witnessing how most of my patients are questioning their values and way of life. They wonder if they’re treating other people fairly and are seriously considering the fact that they have seen people as objects to gratify their own needs. But now, even the more narcissistic patients are contemplating that “where object was, subject shall be.” Now they’re expressing the desire to meet their own needs and at the same time consider other people and their needs – Adler’s notion of enlightened self-interest.

These individuals are questioning their motives, looking at their actions, and are introspective on a scale that I have never witnessed in my 28 years as a therapist. And there are metaphors and ideas that can be incorporated into your practice to help patients to grow and change.

Infection as a Metaphor

Infection and the concomitant need for physical safety is a growing concern for many. One patient wants to get a home alarm system – he’s worried about “other,” and, at a time when crime rates are going down, his fears are, at least in part, a concretization of a metaphor.

Wearing this lens, I asked my patient – as you can ask yours – "If you’re feeling a lack of physical safety, could it be a metaphor for a lack of psychological or emotional safety? What are some other areas where you feel vulnerable? What is the nature of the perceived or actual threat? Have your boundaries been violated, and if so, what did you, your partner, or your parents do about it? Were they the perpetrators?"

Hoarding as a Metaphor

I have been working with patients who hoard to look for the metaphorical aspects of hoarding; a mirror of living amid refuse and/or the safety of “things”. When they have been faced with challenging experiences in the past that involved an element of helplessness, fear, and uncertainty, what have they done to maintain a sense of control?

The over-buying that is happening as a result of the virus can be used to gain a greater understanding of the DSM diagnosable hoarders in our practice. With our own fears of not-enoughness (I didn’t buy 24 rolls of toilet paper until I saw that others were doing it), we can develop greater understanding and empathy for the fear, panic and concern that our hoarding patients feel every day: Not having enough protective stuff. We can honestly tell them that we understand the terror they feel about possibly losing the security of what envelopes them. We can now more fully understand their responses.

The metaphor of hoarding can also be applied to the newly-hoarding individuals who are collecting their water, toilet paper and Purell. If they’re insecure or untrusting, do they obsessively geo-track their spouses or go through the history of their spouses’ phones? Do they covet their friendships to the point where they’re threatened if two mutual friends get together?

Educate your patients about concretization and at the same time show them empathy – that although hoarding ostensibly looks like the need for more material objects, to hoard is an attempt to feel safe, even if those objects prove elusive in providing safety.

Encourage Negative Capability

This time is also an opportunity to help patients learn to have a greater capacity to tolerate ambiguity. It’s what the poet Keats called “negative capability,” which is the ability to live with uncertainty. For those patients, I ask them to live in the question and find the liberation in helplessness. The latter concept means that patients, when faced with a high degree of ambiguity, can either panic and wail, “What can I do?” or they can let it go and say, this time with a shrug, “What can I do?”.

Support Transformational Experiences

This may very well be the perfect time to help patients understand their wish for a “transformational experience” – that thing outside of themselves that they think will make them happy – to be the folly that it is.

Until now, people could fool themselves with this anticipated metamorphosis of “I’ll be happy when.” I’ll be happy when… I get my driver’s license, when I’m married, when I have kids, or when I’m rich.

Sadly, the only patients who already know the falseness of this notion are those who were not changed by these experiences. The wealthy, for example, are the only ones who truly know that money can’t buy happiness. Sadly, many patients still seek changes from the outside rather than from within. This time period may be the window that just opened up to help our patients understand what a true transformative experience is. Ironically, it is this virus and other crises that ARE potentially life changing. And we have a golden opportunity for radical transformation among our patients.

Find Meaning

To extend our capacity for healing, use the knowledge that human beings are meaning-makers. Some patients may unfortunately view the virus as the cop on the side of the road – the one they slow down for but begin speeding up once the motorcycle is no longer visible in the rearview mirror. Or we can use this disease to help our patients to change in a more focused, accelerated way.

Many of your patients may not be ready to hear this. But it’s a way for you to approach the material. What matters now is that you are ready, because we need to help people make positive meaning out of this crisis. To that end, I suggest the book Man’s Search for Meaning by Viktor Frankl – a survivor of Auschwitz – for you and your patients to read.

Prepare to Help Patients in The Future

Yes, this virus is awful, isolating and devastating. But these hidden opportunities can create greater connectedness, compassion and insight.

Millions of people will emerge from the rubble of our former culture in need of our assistance, whether it’s from depression, anxiety, life-changes or post-traumatic stress. They will need us, and we will be there for them.

We are the Healers, the alchemists who can turn this tragedy into an opportunity for growth. Caring, compassionate individuals make up a compassionate society. And we’re in exactly the right profession to make it happen.

File under: The Art of Psychotherapy, COVID-19 Blogs