Mental health professionals have a unique role in tending to the well-being of others. The client is central to our work: we are part of people’s most intimate stories, and it is our job to show up and be present for every client we treat. It sounds impressive, and…it is never entirely possible. Therapists themselves have personal lives and challenging issues to manage. How then, do we do this work in a way that keeps our clients’ interests and concerns front and center?
As marriage and family therapists (MFTs), we receive rigorous training on how to join, build an alliance, and engage in best practices when it comes to working with clients. We receive intense supervision in both group and individual settings. We graduate with at least 500 face-to-face clinic hours, 250 of them working with couples and families. We feel prepared…until we realize the limits imposed on us by something like a pandemic.
As COVID-19 unfolded around the globe, many of us wondered if it would hit us too. The initial understanding of how far this would reach was fuzzy. Once it descended upon us quickly, most of us had to pivot from in-person therapy to telehealth. For those with little to no telehealth experience, this transition feels daunting. It means that our work has to move to a different platform when connecting with clients. All the while, we have our personal lives to manage in a new way.
We are experiencing an unprecedented shift, and it is history in the making. Much change is anxious and scary. We are grieving at least the temporary disappearance of normalcy and managing different degrees of loss, but also working to preserve a sense of stability and continuity. Like our clients, our hands are chapped from sanitizers and soap. As therapists, we must show up prepared for our clients while managing our uncertainty. None of us took a course on how to handle a pandemic, but we did learn techniques that we can apply to ourselves during this time.
Here are some tips from a MFT perspective for all mental health professionals as they navigate their emotional well-being during this pandemic:
Engage in Strength-Based Self-Care: Remind yourself of the strengths you already possess. While we can be acute observers and advocates for our clients, we may find it hard to apply this to ourselves. Your self-care matters, now more than ever. Remind yourself of the strengths that have helped you face adversity in the past and apply them to the present.
Make Room for Uncomfortable Feelings: Give yourself permission to feel your feelings during this transitional time. No one gave anyone a guide to the 2020 Pandemic. We are learning as we go, all of us. We are human first and that means feelings happen to all of us. It is unlikely you would tell your client to dismiss his or her feelings about what is happening in the world at large. We are no different – we, too, must sit with uncomfortable feelings.
Tap into Acquired Resources: Fellow MFTs, our greatest resource during this time, is our ability to think systemically. We know that nothing happens in isolation. Anxiety is an appropriate response to uncertainty. Everyone is feeling it, and you are not the exception to the rule. Remember that you are not alone, and don’t be afraid to tap into the support systems available to you, including your professional association.
Seek Therapy: We need to make space for our feelings during this time. All mental health professionals know that when life is hard, we need to be in our own therapy. Seeking therapy for the therapist is a best-practices item that will help you cope better, while also ensuring that the client’s treatment remains protected from the potential pitfalls that can arise out of transference and counter-transference.
Engage in Professional Consultation: If you are not already part of a professional consultation group, you might find that now is a perfect time to start or join one. Seeking consultation from other mental health professionals helps us process our concerns more clearly. Seeking consult is another way of making sure you are taking care of yourself as well as your clients.
Lead from Self-Compassion: In times of uncertainty, we need to cast a wide net of compassion, particularly for ourselves. It is not easy to do this with a limited personal and professional bandwidth. You don’t need to be perfect. We are all balancing our negative thoughts with gratitude for what we do have. By being compassionate with yourself, you give yourself permission to be where you are and that is okay.
For those of us fortunate enough to have work during the COVID-19 pandemic, we must balance gratitude with uncertainty. We are living through history in the making, and the massive sudden pivot to working from home can be overwhelming, particularly for those without prior remote experience.
Everyone's transition to a remote work schedule will be different. For those who already work from home, the change will be more or less seamless. However, for many, this transition has been abrupt and mind-boggling. Work-life balance has become more daunting than ever before, as it all takes place from your home. Each of us will have a unique challenge to navigate. For a working couple that lives in a studio apartment, for example, it will be more complicated than for those whose space provides more privacy.
There are so many considerations when it comes to navigating all of this "in place." Marriage and family therapists (MFTs) lead from the premise that nothing happens in a vacuum. All of life's demands still exist as you work from home. We are all coping with pre-existing stress on top of the uncertainty that comes with a pandemic. High anxiety about job security is a factor that keeps many of us from setting clear boundaries between our work and personal life. The geographical line vanished overnight, and most of us are scrambling and overextending ourselves to keep from engaging in catastrophic thinking.
As MFTs, we know that setting and maintaining clear boundaries are vital to protecting our mental health. In our field, we talk about boundaries as enmeshed, rigid, or clear, and transparency is the goal. Think of them as your safe zone. Boundaries are about asserting your emotional need for protection. They are not about asking for permission but instead are about letting others know what you can handle. And, as we shelter, work, and play in place, your limits will be challenged. It is okay to be precise about what you can and cannot handle. Others are unable to adjust their expectations and behaviors if they are uncertain about what you need.
Here are some tips for setting boundaries while working remotely during the COVID-19 pandemic:
Hold Yourself Accountable: Setting clear boundaries is up to you. You are responsible for your own needs. It is not always easy to assert your needs, and even more so if you are worried and anxious about job security. However, you are doing yourself and others a disservice by ignoring your needs. Now is the time to use your oxygen mask first, and by doing so, you will be more available to those around you, even from a distance.
Communicate Clearly: Take advantage of the technologies available to you at this time. With so many ways to communicate, we need to make sure we are setting reasonable expectations with our co-workers and clients. It is okay to let your boss know that you are overwhelmed. We all are!
Set Your Hours and Maintain a Routine: When possible, manage your time as you would when going to the office. For mental health professionals, like MFTs, this means keeping a similar schedule to the one you do in the absence of the current pandemic. For other professionals, try to mirror the schedule you kept before the quarantine. And if space allows, create a designated area to work in your home.
Protect You Space: Having work overtake your home can feel bad—not because you don't like what you do but because it infringes on what usually is your personal space. Be sure to keep some part of your day sacrosanct for your own time.
Take Breaks: Just as you would do pre-pandemic, permit yourself to take breaks during the workday. Pushing yourself to be "on" all the time will only lead to additional exhaustion. Take time to eat, hydrate, and stretch.
Be Kind to Yourself and Set Reasonable Expectations: Lead from kindness; no one has done this before. It is a new time, and the rules are unclear. No one expects you to be perfect. Do what you can and let yourself rest when you need to. Keep your expectations of yourself and others within reason. We are all adjusting!
These are trying times for all of us. If you need additional support during the COVID-19 pandemic, please reach out to a mental health professional in your area. Telehealth services are available across the US and Canda. You can find support through the following sources: via the AAMFT therapist locator (AAMFT Therapist Locator),PsychologyToday(www.psychologytoday.com),GoodTherapy(www.goodtherapy.com).
By now, most, if not all, of us are practicing social distancing until further notice. For those with kids, they are homeschooling while trying to balance remote work schedules. For others that may be alone or have no kids or family nearby, or have been temporarily laid off of work, this time is especially challenging.
We must all do our part to help reduce the spread of COVID-19. Social distancing functions as a means of harm reduction by allowing time for tests and vaccine production. It is vital and requires effort. The timeframe on this remains unknown, and long periods of loneliness and worry can increase stress, anxiety, and depression.
Social distancing, while crucial, asks us to suppress our evolutionary hard-wiring for connection. Nicholas Christakis, a social scientist and a public health specialist at Yale University, told Science. "Pandemics are an especially demanding test…because we are not just trying to protect people we know, but also people we do not know or even, possibly, care about." (bigthink.com) And yet social distancing will be a way of life for several weeks, if not longer. It is a test of enormous proportions, and we all need to help each other as much as possible from a distance.
Breathe…we can do this! Before hitting the panic button, try to think of the opportunities that still exist at this time for creativity, care (self and others), and compassion. We are fortunate to have more ways to reach people remotely than at any other time in history. We have tablets, laptops, and phones that function as mini-computers. We can use these platforms to support people outside of our social restriction circle.
A helpful way to reframe social distancing may be to focus on social solidarity. It is a chance to reflect and expand our circle of moral concern. We are in a time of transformation, shifting away from an I-centric approach to one of collective effort and care. We are all in this together, and maintaining our emotional well-being matters.
For Marriage and family therapists, social distancing is part of a systemic response to managing the spread of COVID-19. The discordant nature of it is such that we are helping the more extensive system, our community at large, by intentionally conducting life via isolation. But to repeat…we can do this!
Here are some survival tips for managing life during this time:
During this time of social distancing, you will have ups and downs, and that is okay. Make room for the trying moments, and remember they are just that – a moment, not forever. Maintaining an attitude of optimism is more beneficial to your well-being than dwelling on negativity. Try to choose a healthy mindset day by day, and remember you’ve got this!
Managing fear and anxiety at any time is challenging. No one likes uncertainty, and with so many avenues to information, basic levels of stress can skyrocket. Remember that human beings are survivors. Anxiety is activated by the primal part of our brain, signaling us to fight, flight, or freeze. It intends to aid survival, and yet, as it sometimes functions, it leaves us feeling paralyzed, panicked, and riddled with fear. Remember that this is normal, and everyone will feel some level of anxiety and fear right now.
Given the seriousness with which we are receiving information about COVID-19 pandemic, it is normal to feel anxious. Facing concerns of the developing covid-19 pandemic, marriage and family therapists, as well as other mental health experts, want to remind those with exacerbated anxiety, fear and depression symptoms some ways to manage their symptoms during this time of uncertainty.
New York Time Coronavirus
These are challenging times, and now more than ever, we need to work together in supportive and compassionate ways. From some of the most difficult moments come opportunities to grow. This is a time to redefine our communities in ways that will allow us to feel more connected, despite temporary social distancing.