Life Has Changed. Why Shouldn't Therapy?

Self-quarantine means that just about everything in life is totally different. Outside of our obliterated routines, the way we regulate ourselves has completely changed.

We are social beings, and we rely on engagement with others to help connect with the most important parts of ourselves, the parts that make us who we are. In isolation, we feel an absence, and some parts of our identities might be neglected. This can lead to a loss of meaning and purpose, and a shift towards nihilism.

As the concerns that originally brought our clients to treatment have likely shifted in priority, and the ways our clients are coping with the stress, trauma, and loss related to COVID-19 may have left them less organized in session, it can feel daunting to keep momentum. It may feel that the work we are doing isn't really the therapy that we are familiar with. Using a trauma lens, we can understand that numbing as a protective coping mechanism can lead to a less direct approach to the work. Unfortunately, that doesn't necessarily help the clinician in a session.

Here is a useful framework to shape your sessions as well as to help clients create structure without getting caught in the productivity trap:

• Reacquaint clients with the parts of their experience and identify which they find most meaningful. Ask clients to explore and identify these parts of themselves. If this is a challenge for a client, as a starting point, here are 5 common areas they may want to explore:

1. Erotic energy
2. Intellectual engagement
3. Creative expression
4. Community bonds
5. Spirituality

• Turn some curiosity toward the ways clients were able to engage these parts of themselves before the pandemic vs. now.
• Introduce the idea that if we are not using these parts of ourselves that are intrinsic to our purpose, meaning, and how we embody our lives, our mood is likely going to be impacted, and we will probably struggle to feel regulated.
• Direct attention to how all of these parts of identity feel in the body.
• Highlight some of the small ways we engaged these parts of ourselves when we were able to be social — erotic energy through eye contact, the way we acknowledge or inhabit our bodies when getting ready to leave home, what it feels like to listen to music on headphones while in a crowd.
• Provide new context for missing activities. For example, not being able to go to the gym is more than simply not having a space for exercise. What did that represent for the client? What part of their experience were they engaging? Erotic? Community?
• Check in more than you normally would with clients' Activities of Daily Living, and ask them to walk you through a typical day keeping this framework in mind. What information does this provide?
• Help support your client in creating room for these important parts of themselves in quarantine life. Instead of focusing on a to-do list based on attempts to replace former activities, assist clients in understanding the core of why these activities were important, and honor that in the ways they will structure their days now.
• Process what isn't working with this framework. Is using intellectual engagement to read COVID-19 related content honoring the client's identity? Or is this part of the client better used in other ways?
• Collaborate with your clients on ways to nurture these parts of themselves in quarantine while validating and relating to just how hard this can be.

Reframing the way we spend our time to reflect what is most meaningful, and reconnecting with purpose during a time in which we are coping with feelings of grief, fear, and a loss of control can be a powerful therapeutic tool. Creating a new, thoughtful structure to understand and nurture these most important parts of the person — without pressure around productivity — can be freeing.

Collaborating with clients in this way can not only deepen the work but transform it.