The Uneven Effects of the Pandemic By Roberta Satow, PhD on 9/16/20 - 2:04 PM

I will not be able to see my grandchildren, 6 and 4, once school and daycare begin. Each of them will be interacting with other children. I don't know if the parents of the other children wear masks; I don't know if the parents of the other children wash their hands frequently or use sanitizer after they put gas in the car. So I won't be seeing my grandchildren for my birthday next month.

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

On the other hand, I'm sitting in my house in the foothills of the Berkshire mountains, looking out a picture window at a cardinal perched on my birdfeeder. Last weekend, my husband and I went to Maine and stayed at a B&B. We wore masks when we entered the house, but we had breakfast outside on our own little porch overlooking the garden. We had lunch and dinner outside at lobster pounds or restaurants with large, open porches. Last night, we went to a local restaurant to celebrate our anniversary. It was raining, so we had to sit inside, but the tables were much more than six feet apart, and the server wore a mask. We had a wonderful dinner and felt entirely safe.

I am working with patients by phone, so I don't have to be in my office. We have been in Connecticut for six months now and have no plans to return to New York. I have a patient at 8:30-9:15, drive five minutes to the tennis court, and play doubles for an hour and a half. Then I return home, shower, and have two more patients before lunch.

An online nationally representative survey of 1,004 U.S. adults aged 18 and older by the New York public relations firm of Porter Novelli found that nearly half of Americans (48%) reported that they are anxious about the possibility of getting coronavirus (COVID-19), and nearly 40% are anxious about becoming seriously ill or dying from it. A high percentage (62% of those surveyed) are anxious about the possibility of family or loved ones being infected. The survey also found that more than one-third of respondents (36%) said that coronavirus is having a serious impact on their mental health, and a majority (59%) feel that coronavirus is having a serious negative impact on their day-to-day lives.

These results are compatible with the common-sense assumption that the COVID pandemic has been detrimental to our mental health. But that's not true for me. And it's not true for many of my patients.

My patient Patricia, for example, loves being housebound because when she was a child, her parents insisted she get up in the early morning hours and join them when they opened their retail store. As a result, Patricia hates to leave her house and struggles to get to her place of employment by 10 A.M. Now, because of the pandemic, her office is closed, and she has to work at home. She's in heaven!

Barbara, unlike Patricia, initially complained that she had to work from home. She wanted to go to the office and see her colleagues. She resented having to learn how to use Zoom to work with clients, and she resented having to learn a new app to document her time. But that has changed. In our phone sessions, she has been coming to terms with her resistance to learning technology. She has been talking about her assumption that no one will help her and exploring the ways in which she refuses to ask for help. After discussing this with me, she asked her supervisor for help and was happily surprised at her positive response. Barbara has mastered Zoom and several other programs that she uses for work. She has changed a core belief about herself and her relationship to the world.

We find a similar divide when we look at the impact of the coronavirus pandemic on families. Those who are unemployed because of the crisis—particularly families with young children—are suffering both financially and emotionally. Research shows that increased stress levels among parents is often a major predictor of physical abuse and neglect of children.

The resources many parents rely on—extended family, child care and schools, religious groups and other community organizations—are no longer available because of the pandemic. Child-protective organizations have fewer workers available, and they may be unable to conduct home visits in areas with stay-at-home orders.

On the other hand, many parents who have the luxury of being able to work at home earning their usual salaries and have access to or do not need child care are thriving during the pandemic. My patient Karen, is working from home and her daughter, Becca, is at home taking her college classes via Zoom. Usually, when Becca is at home during college vacations, Karen doesn't see her much because she is out with her friends. But now, Becca cannot go out with her friends. She is having dinner with her parents and spending evenings at home with them.

Karen has always worked full-time and employed a full-time nanny to care for Becca. Karen never cooked dinner for her family; she never liked playing games with Becca; she never wanted to watch movies with her; she never wanted to play outside with her. She relegated all that to the nanny and to her husband. But now, Becca is confronting her. "Why don't you want to play Scrabble with Dad and me?" Karen wants to retreat to her bedroom to read her book or shop online. She doesn't want to play Scrabble with her daughter and her husband. For the first time in many years of treatment, Karen is facing her resistance to intimacy with her daughter and her husband. We have talked about this issue many times over the years, but now Karen is facing it head-on. She is asking herself, “Why do I retreat from my family?”; “Why do I refuse to do the things that would make me closer to my daughter?”

There is a great divide in this country in terms of race and class that has been exacerbated by the coronavirus. But there are other subtler divisions as well that have resulted in the uneven impact of the pandemic on communities and within communities. Some people are drowning from the loss of health, income, and education, others are adapting in growth-promoting ways, and still others are thriving. As therapists, we must keep sight of the unevenness of the effects of the pandemic, empathizing with those who are suffering and encouraging those who are thriving (even ourselves) to not feel guilty.


COVID-19 Pandemic is Taking MH Toll, Finds APA Poll. (2020, April 24). Psychiatric News

File under: COVID-19 Blogs