Therapists and Patients Find Common Ground: Virus-Fueled Anxiety

On a good day, New York City is full of neuroses, a very injured place, where a wide variety of anxieties to scratch the sky can turn into an almost comical crescendo.

But with the coronavirus pandemic on, that anguish reached new heights. Many New Yorkers are trapped in their homes, often crowded with family members or roommates; others must report to work in a contaminated city. They are dealing with isolation and fear; some lost their jobs. Others are ill or in mourning.


It can be overwhelming, even for mental health professionals charged with alleviating these problems.

"I never suffered a trauma at the same time as my clients," said Melissa Nesle, a psychotherapist in Manhattan's Chelsea neighborhood. "Everything I am listening to all day, hour after hour, is what I am experiencing as well."

Nesle added that, at times, the situation was reluctant to relieve patients. "They know to some extent that I'm also sitting in an apartment in New York City," she said. “Then I will tell them: & # 39; Yes, this is really stressful; I understand you; I'm listening. & # 39; But I want to assure them that I'm fine. "


She added: "I am not always".

Faced with the deluge of patient needs, health professionals in the city struggled to adapt. Emergency legislation Enacted by Congress in early March, it has expanded the ability of some psychologists to provide telehealth treatment to adhere to social distance requirements. Some hold remote sessions in parked cars and even in closets to maintain client confidentiality in their own secluded home.


Others found themselves in striking conjunctions with their patients, like a therapist who spent the first weeks of the outbreak in sessions, managing the suffering of others, only to have his 87-year-old father die of the virus at the beginning of last month. .

From the many therapist-client relationships in the city – now in Zoom and FaceTime sessions – a new concern has emerged: mitigating the emotional impact of mental health professionals, who must face virus-oriented anxiety at work and in their personal lives.

After a tiring two weeks of eating through remote therapy sessions, Dr. Lucy Hutner, a psychiatrist specializing in women's mental health, said that the cumulative effect of absorbing the same concerns led her to fall into bed at 7 pm. recently, and pull the covers over your head.

Under normal circumstances, she said she would use her own emotional basis to "analyze the emotional experience of what may be happening to the other person".


"I am so used to feeling angry or sad or a moment of joy for my patients, and it was a completely different experience," said Hutner. "I realized what it was: it was just the fear, the panic, the trauma and the stress that I was absorbing from all sides."


At Mosaic Mental Health in the Bronx, therapists were challenged to maintain treatment continuity: few patients have computers, and many cannot afford to add credits on their cell phones to reach the therapist. Donna Demetri Friedman, executive director.

Your customers are among those most hit by the virus: Blacks and Latinos are responsible for 62% of the city's virus-related deaths, despite making up 51% of the city's population, according to data from the city's health department.

Since the beginning of the blockade, the center has extended far beyond emotional help: its team now delivers not only prescriptions, but meals to patients.

"I do a lot of self-care so I don't assume the intensity of what we see on a daily basis," said Friedman. "But with that, it is so widespread, there is so much death, so much uncertainty that helplessness can arise, in ways that normally don't happen."

"We are doing everything to help each other and our patients to overcome this," he added. "Sometimes, it's crying together."

Many New York City therapists are turning to existing and newly created peer assistance networks. Last month, the American Psychoanalytic Association started a consulting program for navigation on the coronavirus; on the first day, more than 1,000 members signed up for just 245 seats, said Todd Essig, president of the association's new Covid-19 consulting team.

In January, the American Psychoanalytic Alliance of China, which trains Chinese mental health professionals, began training therapists in Wuhan and other parts of China on how to provide telemedicine. These Chinese therapists returned the favor by teaching their counterparts in the best practices in the United States learned through their trials, said Dr. Elise Snyder, founder and president of the alliance.

Some therapists have recruited their own therapists. Others have adopted meditation or built their days around walking.

Dr. Elena Lister, a psychiatrist on the Upper East Side, specializing in loss and grief, separates her sessions to include time to do breathing exercises between each one. In Chelsea, Nesle goes to the roof between consultations.

Others find refuge in routine. Every morning, Richard Angle, a clinical psychologist, drives from his Brooklyn home through the almost empty streets to his office on the Upper West Side – even though he is exclusively conducting telephone and teletherapy sessions.

"I'm a bit of a nerd. I still wear my costume," said Dr. Angle. "Maybe that's silly of me. For patients who can see me, it's maintaining some sense of structure or normality."

Not everyone who seeks therapy has the same concerns, even though the coronavirus is the cause behind them.

The city's clergy are also facing a flood of people desperate for advice, and many find themselves overwhelmed.

"And if they hate God and have a crisis of faith, who do they say that to?" said Dr. Michelle Friedman, an Upper West Side psychiatrist who specializes in pastoral counseling. Through the Jewish Theological Seminary, Dr. Friedman has conducted pastoral counseling sessions for clergy of all faiths. "So, I'm going to try to help them identify what their resilience is."

But Friedman also has a wealth of wealthier patients, some of whom call from their country houses and are comparatively protected from the crisis.

"Whatever the anxieties or problems that are being triggered – a person upset about not having entered his pool yet or someone worried about losing his job – I have to not judge," she said.

Fear and uncertainty have led many already fragile patients to a deep mental health crisis, said several therapists. Some said they needed to have patients hospitalized for their safety, a measure that carries a new layer of guilt over the risk of exposing them to the virus in a hospital.

But there are clear moments: a relationship therapist said that couples who had isolated themselves in close quarters were forced to face their problems and do deeper therapeutic work.

Hutner, a women's mental health expert, says it was her patients who had persevered in the past for debilitating mental illnesses that helped her.

"They have already had an experience of their world turned upside down, only this time it is external and it is usually internal," said Hutner. "It gave me a perspective to understand that people can spend much more than they think, and that includes me."

For some analysts, never revealing self is a professional creed, even now. Mark Borg, a clinical psychoanalyst in Manhattan, adheres to this saying; therefore, he did not tell his patients that, while continuing with the video sessions, he himself had the coronavirus.

But when it got worse, his patients realized, and suddenly the roles of doctor and patient were reversed: “They started getting a cough here and losing their attention there, and my patients started, in a funny and embarrassing way, I have to admit, becoming a caregiver, ”said Dr. Borg, who has since recovered.

"They so desperately wanted it, they needed me to be okay," added Dr. Borg. "So that I can be the caretaker that I am for them."

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