The implementation of the lockdown has been a major cause of heightened anxiety for the general public; even more so for the significant percentage of the British public who have existing mental health conditions. Whilst the majority recognise the necessity of a lockdown in order to prevent the spread of coronavirus, concerns have also been raised about the impact this will have on mental health. A sense of stability, daily routine and close contact with a support network are three things essential to the recovery of a mental health patient and three things that have been rendered impossible by coronavirus. Specific elements of the lockdown can also act as triggers for those who suffer from mental illnesses such as regular hand washing triggering those with contamination OCD, and rising death tolls triggering those with anxiety about death. It is therefore unsurprising that the demand for therapy and other mental health services is higher than ever.
With mobility severely limited and trips to a therapist’s office not counted as essential travel (except in extreme cases), therapists have had to change the way they conduct their sessions, with the majority conducting their sessions over video call or voice call. Speaking about her personal experience, registered therapist Bonnie Williamson said “My clients switched to online therapy. It took only a little while for them to adjust because… all of my clients at that time were under 24 so very used to being online.” When speaking about the switch from conducting therapy sessions in person to online sessions, she said “I miss the interaction before the session, i.e. seeing my clients arrive on my driveway. I miss opening the door to them and welcoming them in and chatting as we climb the stairs. I can’t quite recreate this virtually. People just arrive in the therapy room.”
This new form of therapy raises questions about the nature of the virtual self. Do people feel more or less inclined to open up about memories, thoughts and emotions from behind a screen? With the screen acting as a buffer between therapist and patient, some patients may feel less exposed and vulnerable, and are more likely to speak openly. However, this same situation that can lead some patients to feel emboldened may lead others to be reluctant to share. A therapist occupying space in a patient’s home, even over video chat, may be viewed as a breach of privacy, leading to the patient closing themself off. Another issue with online or phone therapy is the fact that for some patients, the home is not a safe space in which they can talk about the problems they’re faced with. Whether patients are quarantined with unsafe people or simply are afraid that their trauma and feelings may be overheard by another person in the house, many are unable to speak as freely as they would in a therapist’s office.
Lucy* had been receiving face-to-face therapy sessions for close to a year now and began a course of EMDR therapy (Eye Movement Desensitization and Reprocessing therapy, commonly used to treat PTSD) while in lockdown. She says “It’s been quite overwhelming getting used to the adjustment of not only talking to a new therapist but also to entering a full treatment plan… This big change has been quite scary at times, especially in terms of processing the feelings safely afterwards.” When asked about the adjustment to online therapy versus face-to-face therapy, she responded “One of my most difficult issues at the minute is coping post-therapy session. I’m very fortunate enough to still be working (from home), but this often means I have to go straight back into work-mode after therapy. It can be difficult and I get tired incredibly easily, and generally notice that I have to be a bit easier on myself after a therapy session. Being in lockdown I’m finding I have a lot more time to practice the techniques I learn within therapy.”
Being at home also means that patients are more receptive to different types of therapy. Alice* was receiving treatment from NHS service Steps To Wellbeing before the lockdown was implemented. After lockdown, she was referred to a programme called “OCD Net”, a Cognitive Behavioural Therapy approach to tackling OCD using a mixture of lessons and activities. Alice said “I quite prefer the hands-on approach of getting through the material at my own pace independently as a busy student.”
Therapists have had to restructure their sessions and treatments according to the needs and resources available to their patients, resulting in a complete change in what it means to “be in therapy” during lockdown. The lockdown has also had a seismic impact on the mental health of both those with preexisting mental health conditions and those without. If you or someone you know is struggling with their mental health, please contact one of the support lines listed below.
Samaritans 116 123 (free 24-hour helpline)
Mind 0300 123 3393 (Monday to Friday, 9am to 6pm)
SANE 0300 304 7000 (daily, 4.30pm to 10.30pm)
*these names have been changed for privacy purposes
Joanna Magill
Featured image courtesy of Nik Shuliahin on Unsplash. This image has in no way been altered. Image license is available here.