I flip my appointment book back to March 16, 2020. The page is covered in red ink circling the clients I need to contact for virtual sessions. Scrawled across the week’s calendar in purple highlighter is “COVID.”
I start with phone sessions, then move to FaceTime. Four months into the pandemic, I add Zoom.
When I became a clinician, therapy was face-to-face and personal. The therapist’s office was sacrosanct, and the “50-minute hour” was uninterrupted by the world outside. But our world changed on March 16, 2020, and I had to adapt. Fast.
I’m less than a novice when it comes to the Internet, and I felt mildly terrified to add Zoom to my “telehealth” options. Cautiously, after summiting what seemed to me a steep learning curve, I scheduled my first session.
When the day came, I wondered if my client would actually appear in the virtual “waiting room.” I clicked “start” and saw my own face. It was unnerving. Prior to COVID, I’d look in the mirror just long enough to comb my hair and apply makeup before flying out the door to my real physical office.
I clicked “admit” and my client’s face filled the screen. My image, the size of a postage stamp, retreated to the upper right-hand corner. We smiled at each other.
I said, “It’s so good to see you.”
She responded, “Me too.”
My office at home constitutes only one half of our virtual therapy space. The client sees me framed in their screen. On the wall behind me hangs an artwork constructed from an enormous snakeskin in hexagonal patterns of brown and cream. A mobile of the solar system suspended from the ceiling rotates slowly when stirred by a breeze from the open window.
My office doesn’t change, but the client’s other half of our virtual space could be anywhere: bedroom, kitchen, living room, or even outdoors.
I see one client once a month on Tuesday morning. If the weather is warm, our session takes place on her patio. Sometimes, sunlight filters through the overhead latticework to stripe her face with light and shadow. The natural light is lovely, so unlike the controlled environment of my pre-COVID office.
During check-in she said, “Hey… did I tell you my roofing job is finally done? Even the solar panels are there.”
“Wow! That’s great. Can you show me?”
“Yeah. Let’s do it.”
She takes me across the lawn to admire the project. We’re both delighted by this spontaneous break from therapy as usual.
My last session on Wednesdays takes place in a dramatic setting. My client meets with me in his car on the way home from work and parks about a hundred yards from the Pacific Ocean.
Late one rainy winter afternoon we had just begun our session when my client said, “I don’t want you to miss this,” and rolled down the window, turning his iPad so I could see the sunset. Under a canopy of gray storm clouds, the horizon glowed burnt orange. I caught my breath, assailed by a sensual memory of rain, pounding surf and brine drenched air.
My husband and I had escaped lockdown to spend the week after Christmas in the beach town of Gualala. One stormy afternoon we hunkered down in a sheltered cove. Eucalyptus trees danced in the wind, waves crashed against rocks and salt spray stung our eyes. We felt free for the first time since the pandemic. When my client turned his iPad so we could continue our session, I said, “Thank you for the gift. What a beautiful way to end my day.”
Another favorite place is a couple’s bedroom. It’s often the only room in the house where they can have privacy. Talking with two people sitting comfortably on their bed creates a special sense of intimacy.
Sometimes a kid wanders in to see what’s going on, or the dog jumps up on the bed, and couples therapy becomes a family event. In my “real” office, people talk about their marriage, what their relationships with their children are like, and how they parent. In a virtual session, it’s alive, right there on the screen, in the environment where their real lives happen. At times like this I think, what could be better?
Meeting my clients where they are at any given moment in time is essential to the collaborative work we do. It depends on mutual trust, and on the client’s and the therapist’s willingness to be vulnerable. Being invited into the places where my clients live is a brave manifestation of that vulnerability and can take therapy to a deeper level.
A teenager has weekly appointments with me before her first online class, rolling out of bed minutes before our Zoom session. Still in sweats, she plops down on a bean bag chair in her room. I ask, “How’re you doing?” She yawns, wrapped up in a blanket with her tablet on her lap, and tells me about missing her boyfriend, sneaking out to be with friends, and how virtual high school sucks. It feels like the morning after a sleepover. I sip my coffee and relax into simply being with her.
I am honored to be welcomed into my clients’ homes and could not have imagined at the beginning of the pandemic that we would share experiences like these.
Although I’m looking forward to the time when I can return to my office, I will miss our Zoom sessions. Maybe my clients and I will schedule them occasionally… just for old time’s sake.