“I want you to come back to your office,” said Berte*, a client in psychotherapy who has been seeing me by Zoom since the beginning of the COVID-19 lockdown. “I like being in your space. I feel safe and comfortable there, but that’s not the whole thing. I just like being with you in person.”
“I don’t want to go back to my own office, and I don’t want to come to yours,” said Dave*. “I have young kids who haven’t been vaccinated, and I just don’t want to take a chance of carrying the Delta variant — or some other variant — of COVID to them.”
Some psychotherapy clients are feeling a powerful need to be in the same physical space with the person they’re pouring out their hearts to. Therapists, too, are missing the human connection of being across from a client in their office. Yet with the COVID variants and increasing numbers of people falling ill from the virus, people are also talking about the dangers of being in person.
“I miss being with you in person,” said Cindi*. There’s something comforting about you and your office. But I don’t want to be on the subway with all of these people who might not be vaccinated.
How do you decide whether or not to give into that wish to be in the same physical space as your therapist?
Research has shown we are wired to touch and be touched. Even a gentle pat on the back can send soothing and calming messages to our nervous system that soothe and calm us. While the kind of psychotherapy that I do involves very little actual body contact, it seems that being in the physical presence of someone who expresses compassion and caring might trigger some of the same nerve centers in our bodies.
There are a few obvious reasons that both you and your therapist might be struggling hard to find ways to make in-person therapy work again. Therapists try to provide a comfortable, inviting space for clients to do the hard work of exploring the sometimes tumultuous and often painful inner world of their thoughts and feelings. Walter*, a recent college graduate who moved back to his parents’ home during the pandemic, told me, “I like the privacy and the quiet of your office. I can hear myself think, which I can’t always do around my roommates or my parents.”
During the pandemic we all created therapeutic space in bedrooms, dining rooms, cars, and even closets and bathrooms. But your car isn't your therapist's office, and a closet, no matter how what the how-to pundits tell us about creating an at-home office, isn't cozy, sound-proof or child-proof. And while remote sessions give us a closeup of each other’s faces, they also sometimes reveal a little too much personal space. “I feel like your space on Zoom is just like your office. But I’m embarrassed that you can see the marks on the wall and the mess on the shelves behind my bed,” said Ana*, a working mom whose home office space was a corner of her bed. “I don’t care about going out to eat or having friends over for dinner,” she added. “All of that can wait till the pandemic is truly done. The one thing I want almost as much as I want my children to be able to go back to school in the fall is to be able to come to your office with a cup of coffee and sit down to talk, in person, with no distractions, for a full forty-five minutes.”
Many of my colleagues who work with children and adolescents went back to their offices as early in the pandemic as they could, because they felt that their young clients needed a physical connection with their therapists. And, despite having grown up with social media, FaceTime and other forms of remote contact, many youngsters have had a hard time connecting, concentrating, and staying focused for online therapy sessions.
A friend recently told me that her therapist suggested they return to in-office work for yet another reason. “We can read each other’s body language in person, which we can’t do very well on Zoom, since all we can see is each other’s head, neck and shoulders.” A therapist can tell something about how a client is feeling by the way they walk into the room, sit in the chair, and move their body during a session. Similarly, a client reads compassion not only in a therapist’s eyes and face, but also in the way a therapist leans forward in their chair.
Psychotherapists have become more aware of the interplay of our bodies and our minds in recent decades. So even though I don’t do any kind of physical bodywork with clients, I am very aware of how our bodies can join our conversation. For instance, if a client moves uncomfortably on his chair, I make a mental note of it, and at some point might ask what they are feeling physically at that moment. Because, as author and trauma specialist Bessel van der Kolk put it in the title of his famous book, “The Body Knows the Score” — that is, our bodies often know what’s going on with us before we can put it into words.
On the other hand, for therapists and clients, it can be more convenient to work online. Clients have said they would rather not return to the 90-minute round-trip commute to my office. “I can do a lot of other, more productive things with that time,” is a common response when I ask if someone wants to return to in-person sessions. And therapists tell me that they love having extra time as well. While some people feel that having their therapist see their living space is crossing a boundary, others feel that sharing their living space makes the relationship more personal and less distant. Over the course of the pandemic some clients have asked if I would like to see their homes and have shown me emotionally important pieces of memorabilia I might never have known about in the “old days” when we worked in my space only.
It seems that we’re going to be stuck in ambivalence for a while longer, as the Delta variant surges and anxieties about contagion and next mutations of the virus increase. Messages about what’s safe and what’s not, and support for the actions we need to take to protect ourselves and others are not always quite as clear as we might like. Like a number of my colleagues, I have put the brakes on my own plans to start a hybrid of in-office and remote therapy this fall.
Berte* says she gets why I’m not ready to come back to my office full-time. “It’s probably a good exercise for me to imagine being with you in your space,” she said. “My yoga teacher tells us all the time that imagining ourselves doing poses fires some of the same neurons and triggers the same muscles that would be working if we were actually doing the exercises. Maybe just imagining being in your office will help me feel better.”
Perhaps she’s right.
- names and identifying info changed to protect privacy
- photo credit: 123RF stock image #154857247 mikos
