Day 60 – I Hate This

Photo credit Gerd Altmann, Pixabay

It is Day 60, also known as May 14, 2020, and here is what I hate about this.  About Isolation.  I have said before, I am one of the lucky ones.  I have a nice place to stay, am not facing potential eviction or starvation, and I live with someone I enjoy being with.  I am married to my very best friend.  It doesn’t get better than that.

But having gone to graduate school to become a mental health counselor, then taking continuing education courses and doing my best to stay abreast of the latest developments in trauma treatment, I would really like to be able to make more use of my knowledge.  And above all, I would like to be more available to my clients.

Online counseling is a growing field, and I have not grown extensively with it.  Of course, I did not see this coming.  Or did I?  I have heard for years that we could get brought down by a pandemic, and I felt that was probably true.  I mean, we all know there are gene mutations and we have had other viruses crop up.  My first memory of that is Parvovirus in dogs.  That was followed by MERS, SARS, Ebola in humans…  With these viruses ultimately controlled at least to the point where they did not threaten the entire American population, I convinced myself this was for medical people to deal with.  So I didn’t think further, in the sense of not considering how a new and unstudied virus could impact day to day life.  I knew all about quarantines from times gone by, yet neglected to think it could happen to us.  In 2020.

And here we are.  I can still learn more about online counseling.  I have the tools:  FaceTime, a Zoom account…and my telephone works just fine.  I have been outspoken, though, about my preference for face to face counseling, and that preference has not changed.  My clients have expressed similar feelings.  Though a couple of clients have taken me up on doing a couple of phone sessions, they are mostly showing zero interest in using technology for their sessions, preferring to just wait this out and see me then.  That is fine with me; I would likely make the same choice.

The problem is exacerbated in a way I did not predict:  The stress of living with this pandemic creates emotional problems for everyone.  Though this may be an oversimplification, it appears to me that everyone is either isolated and bored, or has a minimum work week of 80 hours.  There doesn’t appear to be much in-between.  It is definitely taking its toll.  And just when everyone would like to talk to their counselor, assuming they have an established counseling relationship—that counselor cannot see them face to face due to the risk of spreading disease.  After all, many people have the virus and are asymptomatic, so we never know if we could be infecting someone, and that would certainly violate the directive of Do No Harm.

Here is what I can do:  I can remind you that if you are feeling stressed or if you are having trouble focusing and/or getting things accomplished, this is a normal reaction.  If you obsess on hearing every little COVID-19 story, this is also a normal reaction.  Probably just about everything you may deride yourself for is a normal reaction.  This is a traumatic situation, after all, and trauma responses vary from situation to situation as well as from person to person.

If you are feeling extreme depression or anxiety, and/or an urge to hurt yourself or others, please go to your nearest emergency room.  Or at least call a hotline.  Or call me.  (Disclosure:  Since I don’t have other people backing me up, you may have a wait time before I return your call.)  Some people will be pushed past their limits by this crisis.  Do not be ashamed if you are one of them.

There is an excellent Centers for Disease Control web page, cdc.gov, with info about dealing with COVID-19.  It gives the Disaster Distress Helpline, 1-800-985-5990, or texting TalkWithUs to 66746.  Also, since domestic and intimate partner violence increases during these crisis times, please be aware of the National Domestic Violence Hotline (also listed on cdc.gov), at 1-800-799-7233 and TTY 1-800-787-3224.  

You do not need to be ill or have someone close to you suffer from COVID-19, in order to be affected.  This is a worldwide crisis, and being affected by it does not make you a weak person.  Repeat after me:  “I am not the problem; this crisis is the problem and I am doing the best I can.”

e-Counseling and Ethics

diital-touch-310257-sI have been hearing a lot lately about “e-counseling”. I have no plans to join that movement.
Anyone who comes into my office deserves a personal counseling relationship, which is absent in “e-counseling.” You will see the word in quotes here because I don’t regard it as true counseling.
A critical part of my professional work involves watching your facial and body signals: Are you hesitant, bold, teary-eyed? Are you unable to stop nervously tapping your foot? Are your words in sync with your facial expressions? Is your voice shaking?
Some would argue those things can be picked up in a Skype interview. I would argue that they cannot; it is not the same as being in a room with someone, with the feeling you are in that safe place with a caring professional. And Skype is not HIPAA-compliant.
To me, “e-counseling” is a high-priced version of Dear Abby. Or if you go for the better quality advice columnist, Carolyn Hax. Ms. Hax is a true professional advice columnist, excellent at what she does. She is thoughtful in her answers, and leaves the reader with plenty to ponder. And she does not pass her column off as “e-counseling.”
You know what happens when you send off a hurried e-mail, and it gets misinterpreted because your facial expressions and body language could not be conveyed. Frequently the words alone are inadequate.
Are there times when “e-counseling” can be beneficial? Yes. If you are located between nothing and nowhere and cannot physically get to the counselor’s office. Or if you have already established a counseling relationship before you move out of state. But it’s really not the same.
What about benefits to using the internet before seeing a live counselor? Some people do this in order to screw up the courage to call and make that first appointment. Great. So long as you are aware of both the benefits and limitations.
I received an actual survey from a company that fully intends to set up an “e-counseling” business and wanted my opinion about what was and was not ethical to do. That strikes me as very similar to saying “What would be the most ethical way to mislead your sister?” There isn’t one!