Declining teletherapy before it was cool, and now the risks to life

At one of Dr. Ross’s hospitals, we had the opportunity to have a public (in front of all patients and staff on the Trauma Ward), one-hour therapy session

We had seen this session before starting in 2017. Dr. Ross would fly into town, visit the ward, and hold a public therapy session once per week. Maybe on a Wednesday, say.

Many patients in the “audience” would fall asleep or read/write/color, etc. We would listen. Dr. Ross would ask questions of the patient. Lots and lots of questions. He gathered a lot of information: whom you grew up with. Major events. Whom you live with now. Major events. How you judge yourself. And then he would point out any inconsistencies in self-perception versus other’s perceived perceptions of you, your value, etc.

We found it veryinteresting: the process, his thoroughness, the showmanship—not in a haughty way. It’s just that the day room (this was a locked ward) or group room was dripping with therapists and psychiatric interns and patients.

Dr. Ross seemed like a very effective therapist. Still, we watched and thought that we might not enjoy the “hot seat” of being scrutinized publicly. Some patients would cry, some would switch to angry me’s, some would reveal nothing extraordinary and Dr. Ross would just let the session be what it was. He did not seem to embellish. If anything, he could handle very traumatic and dramatic information with calmness, matter of factness without being cold.

We are not ones to gawk at other people’s trauma. If people say, “Trigger Warning,” then we don’t read or listen. We do not want the images, especially because they are real. These horrible things happened to real people with whom we are breaking bread, sharing a bedroom, caring about, whatever

We were in the hospital to deal with our problems, not to take on other’s. But the Dr. Ross sessions were just so living, breathing, organic. And he was so adept, attuned, empathetic. It was very relatable. The process of his work was memorizing

He didn’t come back the next week while we were still there in 2017, and some patients were let down. One actually left the facility partially because of his absence. That patient wanted to be Dr. Ross’s patient, was counting on it. The doctor took vacation and didn’t appear.

We thought that was reasonable. We were not there to see him. We are not big on cult of personality (we like the song, though). We do not imbue one therapists with the ability to heal us in one session. When we worked a job for pay, some of the students would fear or respect (our both) us because of our position of authority, and we were not comfortable with it, were irked by it

The next year we were at this hospital and Dr. Ross came weekly. The day before we were to be discharged, we were asked if we wanted to be the patient for his session. We declined because what if he stirred shit up and then we couldn’t leave? We saw it happen to other patients. One got so into a flashback during his season that the patient’s stay was extended by weeks. No thank you

Last year, 2019, Dr. Ross’s weekly “visit” was via the Internet. Some people said he had been sick and so avoided coming in person. We watched the sessions. There was some glitching of the Internet during therapy. We had anxiety about it. We have an intense fear of being misunderstood. Also, the Internet did not allow the same exchange of energy and pathos as in-person sessions. We still watched, and now it felt somewhat cringy to us.

We were asked to be the patient near the end of our stay and we said no. We said that we did not want to try to have therapy via the Internet. It was less precise than in-person. Some things that you say out loud, you cannot handle hearing, “I’m sorry, can you repeat that?”

No. Thank. You.

We declined the teletherapy session.

Fast forward eight months from then, and Covid-19 hits. All our therapists went virtual. We tried it. We liked not having to drive to the appointment, as traffic feels stressful to us. We enjoyed not sitting in a waiting room or waiting in the hallway for T-1 to unlock the waiting room first thing in the morning. We are very uncomfortable around strangers. We sometimes present in gender fluid ways and do not want judgment

The therapy sessions via the Internet we did not appreciate: bringing our trauma into our living space felt unsafe, contaminating. With people in our house, we felt not private, constrained. Therapists said they felt similarly in their homes. T-3 had to tell a child who came into the therapy room (T-3’s bedroom) to go ask Daddy while we were on teletherapy.

It was messy. Too messy for us. Cost too many forks. So much anxiety before, during, and after. Was that just Covid stress or cumulative changes? Probably all the above, right?

So we tried cars, which you might know from our prior posts. We are currently seeing two therapists weekly in our cars

And today we had our first in-office visit with a new therapist since COVID-19! T-5’s office never closed. They offer Telehealth and 40% of T-5’s patients accepted.

T-5 seemed genuinely shocked to hear that Ts are scared and that clients feel like they have to take care of Ts. Maybe T-5 will prove to be a stable influence, an anchor

Attention all Ts: this is an epidemic. Many Ts are so scared that their previously self-proclaimed boundaries are eroding or gone.

We, the patients, need therapy to be about us! We cannot give you the therapeutic support you need. Hearing about your employment and family struggles is so triggering and confusing that we do not know how to survive at this point.

Yes, you are human and deserving of compassion. You have needs. But if you weren’t sharing at this level before the crisis, does this mean boundaries are fluid? This changes the therapeutic dynamic as you had previously defined it. How can we put the genie back in the bottle once you return to in-office visits? How do we survive now with no solid ground? You were our rocks!

Patients, you can contact your health insurer (if you have one) and primary doctor/GP (if you have one) or a social worker and ask for a list of therapists who are seeing clients in person, if local ordinance permits it

You can also set your own boundaries with Ts. T-3 shared very personal information in session. T-3 asked if we wanted to hear another story about T-3. We said no. We explained the boundary confusion. Yes, it was awkward. We can’t meet Ts’ needs

We can’t even believe T-5 lives in the same world as our other Ts. We are so disoriented.

T-5 says that living in fear (which we do) and living with no fear are extremes. You are close to falling off the edge with either.

There is a middle way that allows for more flexibility.

We thought about the risks. Yes, we may contract the illness and people may die. We think our mental health is just as important as our physical health so that we are meeting in person and taking some precautions (not masks). For us, it’s worth the risk. It’s okay if you would not act similarly. Ts 1-4 are not allowing in-person therapy, so who knows what they will think

We are trying to stay alive—find mental health— even if it kills our body. Hard choices to have to make. Some of you may know we have a primary immune deficiency that leaves us susceptible to airborne illness 😕

Challenging choices. Unprecedented challenges. Not quitting yet

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