Why Would a Therapist be Silent During a Pandemic?

Like nearly everyone, I’m keeping an eye on health-related news, taking extra hygiene & sanitation precautions, & wondering what our collective future holds. I switched to virtual therapy & am staying away from people. Beyond my announcement that we were moving to virtual therapy, however, I have been professionally silent on the topic of COVID-19, yet this is precisely the circumstance in which many folks want to hear a therapist speak. Perhaps they’re yearning for guidance, words of comfort, or a touch point from which they can determine whether or not they’re doing this whole thing “right.” Yet here I’ve sat…outwardly silent.

In my earliest training as an Air Force officer, I was introduced to Colonel John Boyd’s OODA loop (Observe, Orient, Decide, Act; pronounced eww-duh). There are layered virtues in Col Boyd’s approach to decision making. It encourages us to be critical/objective thinkers, to not act rashly in ways that can cause harm, but also to ultimately act…to not be frozen in fear or indecisiveness. In daily life, we OODA loop repeatedly, & we may have to OODA multiple facets of the same situation.

Case in point, I first had to OODA the question of when to move to virtual therapy. I first observed what was unfolding…keeping tabs on world, national, & local news. I had to devote proactive attention to orienting to relative threat, proximity of said threat, & my responsibilities to my patients. I then decided on March 15th to offer virtual therapy to my at-risk patients & acted on that plan. I OODAed again to make the decision on March 17th to move to 100% virtual therapy.

Panning back, I’ve had to OODA whether to publicly comment on COVID-19, &, if so, what to say. I’ve watched corporations’ commercials. Some are lovely…while others’ are tone deaf. I’ve watched the emergence of a new breed of ads on social media…companies capitalizing on people’s fear.

And I’ve watched an avalanche of therapists’ recommendations for staying calm (etc.) come in through every communication source I access. I’ve fully read many & have casually skimmed many more, & I keep getting hung up on how non-universal & trite a lot of the material is. Don’t get me wrong: There’s helpful advice in SOME of it for SOME people in SOME situations. But the operative word is clearly “some.” There is no panacea in this…no solution for all people, all mental health statuses, all sets of contingencies.

This has heavily influenced my silence. As I observe & orient to the current pandemic, I think of my years of working privately with individuals & their highly variable situations & psychologies…even when they share a diagnosis. They each need to hear something different from me & at different paces & for different reasons. A practicum supervisor once said to me, “In clinical psychology, as in comedy, timing is everything.” These thoughts always give me pause when I contemplate a public statement. What I say has the potential to help one person while hurting another.

I don’t want to be guilty of being tone deaf about the widely variable situations & mental statuses of individuals who may come into contact with my words. And I certainly don’t want to cause harm.

One of my patients recently said, “It’s hard to figure out where to land in of all this. I don’t know. On a scale of zero-to-apocalypse, where are we?” I was intentionally silent initially. I allowed it to be a rhetorical question & just sat with them through the uncertainty. I know this patient well enough to know it wouldn’t be helpful for me to rush to fill the air space. Fact is, we’re all uncertain, so it would’ve been disingenuous for me to provide false or ill-informed platitudes. I let them know that they are part of a human community that is similarly concerned & uncertain….& that even in our uncertainty, we’re in this together.

Another patient (a medical provider) went from describing their concerns about their vulnerable patients, epidemiological projections, & the availability of PPE….to pondering aloud about large scale societal & economic impacts. I abruptly stopped them & forcefully told them that they don’t have the mental or emotional bandwidth to contemplate that right now. I know this patient well enough to know that this internal rabbit hole would be destructive, & that they have historically responded well to overt redirection. I affirmed their concerns but advised them that – for their own sanity & the viability of the service they provide to the public – they needed to preserve their fuel to focus on caring for their patients.

Bottom line is that therapy isn’t conducive to one-size-fits-all advice. While diaphragmatic breathing might calm one person, going for a run might calm another. And while some people currently have the mental space & available time to do both, some of our essential workers or at-home caregivers have the mental space & available time to do neither. Who am I to tell them that they’re doing a pandemic wrong? When someone is in abject survival mode, who am I to give elementary “solutions”? Sure, I encourage self-care & self-compassion as much as the next therapist, but when someone is caring for their medically fragile child, caring for their elderly parent, homeschooling their kids, & mentally wrestling with their spouse’s loss of income, who am I to sideswipe them with the suggestion that deep breathing will make their life better? That’s not what they need to hear from a therapist right now.

What they need to hear goes a little more like this: This sucks. You’re in survival mode, & you only have the bandwidth for the essentials. There are so many unknowns, & no one can clear any of that up for you right now. Do what you need to do to keep your head above water, & if that means sitting on the couch like a potato before bed, then that’s what you need to do.

This does suck, folks. And there are no simple answers…no magic pills. Your therapist is as uncertain as you are, because we were never trained in infection control, epidemiology, or pandemics. We’re fleshy humans just like you. (Seriously, I continue to shut my ponytail in the car door on a regular basis. I’m a gold-medalist at pouring coffee down the front of my shirt. And I can’t pronounce the word “anonymity” or spell the word “parallel.”)

All I know at this point is what keeps me sane during hard times: I strategically focus on the goodness in humanity…stories of humans being good to one another. I think of all the things I have to be grateful for. I focus on one thing at a time, which sometimes takes lists to organize & put aside that which I can’t attend to at the moment. I nurture my relationships. I mentally dump extreme positions & stories…& instead take in the numerical average of all points. I remind myself of the hardships I’ve survived to put in perspective my ability to persevere. And I laugh…vigorously & often, because humor always takes the edge off.

Hang in there, everyone. This sucks. But there’s no definitive right or wrong way to mentally navigate a pandemic. We’re all doing the best we can, & we’re all in this together.

Joye Henrie, PhD
April 2020