Virtual Therapeutic Connections During the Coronavirus Pandemic

Virtual Therapeutic Connections During the Coronavirus Pandemic

I cannot see my client Molly* over the phone, but I know she’s crying.  I can hear the slow gasps and know she’s sucking in her breath, trying to hold back the wails we both know are only seconds away.  I’ve been here with Molly before when she was in the midst of a horrific divorce and custody battle and overwhelmed with emotions, but it was face to face, in the therapy office, not over the phone. I try my best to visualize her there in her home, a noisy and cramped two-bedroom apartment from what she told me during previous sessions and wonder if she’s sitting on the couch, perhaps in an effort to replicate the therapeutic experience. Or maybe she’s perched on the edge of her stepstool - the one she told me she found an antique store the week after she signed the lease for the apartment – gazing out of the kitchen window.
My hands clutching my iPhone are moist with sweat, and I take notice of my own breathing.  I hadn’t realized I was that angry until now and make a point of discussing this with my supervisor. I’m also exhausted. It’s as if my body is processing all the emotions I’m feeling. Or maybe it’s the other way around. I’m annoyed- at the virus, at the systemic injustices, which have always been an insidious threat against the marginalized population groups I’ve chosen to work with, at myself, even, for not being the perfect therapist during such a trying time.

 I’m frustrated with Molly.  Therapists refer to their emotional reactions regarding their clients as countertransference. Mental health professionals engage in ongoing supervision to discuss the ways their thoughts and feelings about the people they are trying to help can impact the therapeutic process. I generally meet with my supervisor weekly, but we have been speaking over the phone more frequently during the past couple of weeks to ensure we are providing optimal services to meet the diverse needs of those we serve.

            In the wake of the Coronavirus pandemic and social distancing protocols, psychotherapists have turned to technology or telehealth as it is called, to continue providing emotional support. When I stopped seeing clients in the office, I offered them the option of using Zoom or similar HIPPA-compliant platform where we would be able to “meet” over the computer screen or talking over the phone. Molly chose to have our therapy sessions over the phone. Perhaps once we have moved beyond the immediate crisis of our collective trauma in coping with this pandemic, it will be useful for us to explore the reasons why she preferred the phone over Zoom.  Maybe she feels safer shedding tears I physically can’t see? Perhaps seeing my physical home office and allowing me a glimpse into her natural habitat feels too threatening? Clients share information with their therapists in diverse ways.  Verbally, through body language, by the choices they make, such as canceling an appointment at the last minute, or the way they sit on a chair and uncross their legs. The nuances of each and every interaction between client and therapist are vibrant, and the skilled practitioner is continuously observing.  Learning when to speak and when to stay silent takes years of practice. 

            We are in the midst of harrowing and traumatic times. The fear of the unknown, a seemingly endless procession of what if’s and when will this end, revolving door rhetoric of sorts, plagues many more of us than the COVID-19 virus itself. The emotional fevers we are likely to spike during this coronavirus pandemic need empathic care. Folks who can’t breathe because their chest is tight need a psychiatric ventilator. Exhaustion may very well be the new norm we wear like those makeshift scarves we tie and turn into masks, but that doesn’t make it feel comfortable.  
Psychotherapists have advanced training in crisis intervention and human development. We are adept at adapting to stressful situations and strive to build and maintain safe places for those we counsel. And not entirely unlike the makeshift tent hospitals sprouting up across the country to accommodate the overflow of sick patients, therapists are building space virtually. We are using technology now to foster deeper connections. Historically, therapists trained to meet people where they are. Thanks to technology, we can connect therapeutically with more ease and flexibility.  Not unlike the emergency room physicians, intensive care nurses, and other first responders saving lives on the medical frontlines, therapists are busy fighting another side to this virulent pandemic. We are also making unprecedented sacrifices to ensure we meet the psychological needs of individuals during this time of uncertainty, pain, and loss.

*not her real name.

Tammy Smith

Tammy Smith lives and works in New Jersey as a psychiatric social worker.  She draws her inspiration from her mental health advocacy work. Her writing has been published or is forthcoming in The Esthetic Apostle, Ailments: Chronicles of Illness Narratives, and in io Literary Journal.


  1. the best article I read so far on how telemedicine can have a positive impact on the lives of the vulnerable.

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