You enter a therapist’s office, there are objects which offer a sense of familiarity; a chair/couch which allows you to feel comfortable; and your therapist, offering water or a word of acknowledgment. These are vital aspects of therapy, possible only when two people are in the same room, sharing the same space, face to face across just a small physical gap.
The year 2020 will be remembered for very many reasons, some good and some evidently not good. The thing that stands out most perhaps, is the whirlwind evolution of our online presence. Amidst Zoom board meetings or virtual graduations; computerized entrance exams or online shopping sprees, mental health certainly did not take a back seat. Mental health counselling took a turn none of us anticipated, or quite frankly, were prepared for. The very core of counselling and talk therapy rests on the client-therapist alliance and the therapeutic bond that emerges from it. And now suddenly, we are expected to achieve that over the ‘poor connection’ of video calls. Not to mention, there was new wave of individuals in need of mental health services caused by loss of loved ones, loss of occupation, and a general impending feeling of hopelessness. With the lockdown in full motion and more than enough time to spare, individuals were forced to deal with moods and emotions, traumas of the past and concerns of the future-that had been kept at bay until now, perhaps circumscribed by the everyday motions we all throw ourselves into to keep our minds occupied.
The experienced professionals of the field could slowly convert their practice into a virtual one, having already created the rapport that supported the therapeutic process. However, there was a section of newly appointed mental health professionals who had spent the last few years training for a scenario that no more existed – the graduating batch of 2020. There were and are numerous challenges in starting your practice on an online platform. Firstly, the satisfaction of finally being a working professional got lost in the move from ‘bed to study table’ instead of to an actual work place with other professionals, which would eventually mark the beginning of our careers. Secondly, we now entered a sphere of work which our training had not entirely equipped us for.
We spent years learning theories and techniques that applied to the human psychology, symptoms and affects that could be observed in a one on one, face-to-face counselling set up. We are now forced to gauge the intensity of a client’s emotions on a pixelated screen. Certain techniques such as the SOLER model which talk about various non-verbal cues including eye contact or the posture of the client; observing and analyzing the silences in conversations; working on the transference caused by the physical presence of an individual - each of these nitty-gritties were up to undergo a transformation. Not to mention how an online meeting compromises the discipline and accountability of the process. It’s much easier to cancel a scheduled call than an in-person meeting. In a culture like ours where mental health is still trying to make a permanent place in being a vital medical service, its importance and value is diminished severely by the virtue of being conducted on a ‘call’. The physicality of it all impacts the sessions- having a weekly routine of going to your therapist’s office adds to the stability and value of therapy. Clients know what to expect, they allow themselves to open up in this room and associate it with comfort and safety.
But much in the spirit of our profession, we tend to see the glass as ‘half-full’. The virus forced us to go online which in turn opened up the possibility of availing mental health services for many individuals who didn’t have the provision earlier. Individuals with extremely busy schedules, who couldn’t drive or afford public transport; individuals who didn’t have the freedom at home to step out without informing caregivers (who weren’t open to therapy) and those with inflexible work timings, are now able to attend sessions from the comforts of their home. A bigger plus point is seen for those who have trouble in social interactions. Without the need to face someone in close proximity, they are able to communicate much more openly and are able to discuss intimate details of life in a secure manner. A survey conducted by American Psychiatry Association showed that before COVID-19 hit, only 2.1% of their respondents reported using tele-psych 76-100% of the time. During the pandemic, that figure has soared to 84.7%. Having a conversation on the phone doesn’t seem as daunting as booking an appointment and actually visiting a therapist’s office.
The pandemic also provided an opportunity to small business that promote mental health well-being to grow and cater to the changing needs within the landscape. We are asking questions, understanding its importance, criticizing certain practices- but we’re talking about it. Platforms like my own (The Burrow), aim to make our services accessible as well as increase awareness about the need for our services.
2020 will be the year of the pandemic, but it is also the year when mental health took great strides in becoming a widely known concept and the awareness of which helped us all to cope with the challenges that lie ahead. The inevitability of the triumph of the human spirit remains the most exhilarating truth to come out of this.
Anoushka Akhouri is a counselling psychologist and co-founder of The Burrow.
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