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Making Telehealth Work for Clients in a Busy Home – Working with Parents During Quarantine

7 Comments

Even for people fortunate enough to be able to stay safely at home, the pandemic has created a lot of new challenges.

Many parents are feeling the strain as they try to homeschool, work from home, keep the house together, and plan activities for increasingly cooped up children.

So in the video below, Bonnie Goldstein, PhD, shares how she helped an overwhelmed parent find a way to focus on her online sessions without distraction – despite being in a busy home.

 

 

Click here for full transcript
Dr. Goldstein: So, at this time where so many families are feeling the pressure of not knowing what to do in this new normal, as a family practitioner, I’m finding that I’m getting more parents saying how inadequate they feel. One mom said, “I never signed up to be a homeschool mom, and a stay-at-home mom, and a housekeeper, and, and, and, and, and . . .” She was feeling so overwhelmed and also because the way she organized her life, through the lens of sensorimotor psychotherapy, the self-reliant person who’s so busy doing, doing, doing maybe has a sense, as this client did, that nobody can do it as well, maybe has a sense that her value or currency in life is her being able to do. So, she was describing baking cakes, working on her birthday parties for her little ones, fixing these home experiences, lining up all the neighbors, so that they could drive down the street staying six feet apart, but everybody had signs out saying happy birthday first to the one kid, and then four days later the next kid, and then the father five days later.

She hadn’t taken the time, until we started looking at this, to check in with herself. The words “pity-party” come to mind – her words. She said, “I have no reason to pity, I’m lucky, I have a house, I have food. There are so many people who are ill, there’s so many people who are struggling, this is horrible that I am presenting this in therapy.” We wanted to together collaborate and find a way to look at that sense of what was really shameful. She was feeling shame that she had any feelings other than gratitude. Of course, we can look at the gratitude piece, but right at this moment, our entree was to look at that shame that she felt that she couldn’t count on herself, that she couldn’t be there and present for herself, that she was feeling physically exhausted. Again, she said, “I’m not sick, I know I don’t have the virus, so I should be grateful. But I just have headaches, I’m tired and always lethargic and I know I’m not sick.” So there was that duality of not giving herself even the tiniest window.

So, I would play with her with, “Is there any part of you, even like a sliver of a moon, using the poet David White’s nomenclature, just a sliver of self-compassion for all that you have been caring for and doing?” Maybe even embracing – in her words – the pity party. “Let’s together erase the pity party, let’s embrace that part of you that really has never lent itself to being embraced,” and even as I spoke giving back her words and I slowed down my tone, as I am right now, the emotion crawled in. She was able to experience the deep, deep sadness and the sense of aloneness that she felt nobody was able to take care of her and that she was unable to take care of herself and she wasn’t doing an adequate enough job taking care of her kids. She had forgotten to take over her own needs, even the therapy session was interfered with kids running through and distractions and she didn’t have the containment that she had in our office.

So that was one really important thing you had to do is say, “How do we carve out a time for us to have a session where you don’t feel pulled in a million directions, where you were able to just be with me in the session and therefore just be with yourself in this?” For her, she set up our session in the bathroom, she said that’s the place she could lock the door. There was nowhere else in her house that she felt she could go where she could truly be on her own, in the quiet, in the containment. In her family, that was the respect, people respected locked doors, so there she found a space, but we decided together to make it not the space for elimination, but the space for her to embrace. She brought in her glass of champagne because she said she wanted to be able to feel the joy the bubbly brought as associations from better times. She also lit a candle, and for her, it was an aroma therapy candle. I, too, lit one of my candles – we have candles all over the offices – so that I was able to join with her in that. We joked about how my glass of champagne wouldn’t be champagne, but it didn’t matter, my cup of tea was what worked for me. And so together, we were able to bond, we were able to joke, we were able to share that human offering.

 

How have you helped parents who are feeling overwhelmed during quarantine? What has been the most effective strategy you’ve found to help them?

Please share your experience in the comment section below.

If you found this helpful, here are a few more resources you might be interested in:

Working with the Nervous System via Telehealth

Practical Ways to Improve Telehealth Sessions

How Parents Can Create Impactful Moments of Joy for Their Children

 

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Related Posts: Compassion, COVID-19 Pandemic, Shame

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7 Comments

  1. Struggling Mental illness survivor, Other, CA says

    I truly believe adding the option of telehealth or video conferencing is so important for those who physically cant get to therapy. However as someone who struggles with PTSD and lives with someone who still is interwebed in my trauma recovery (someone I wouldn’t want to over hear my therapy sessions) while it’s great to have access to clinicians this way when there is no other option however in the long run when the pandemic calms and things begin to find new normal I hope in person therapy can still be a thing. Even for me just having that as a reason to leave my house and having to force myself to get dressed to go to appointments and having that social interaction it is a make or break a lot of the time in my recovery and while I feel alot of guilt and shame for thinking this way when this virus is killing people… mental illness in this pandemic is also killing people.

    Reply
  2. Srishti Nigam, Medicine, CA says

    To Be Frank “Virtual Online Therapy is Utterly useless and truthfully waste of Health care dollars.” These are Chronic conditions started as dysfunctional emotional Patterns in early childhood, that most of us practice Unconsciously.
    However for acute crisis,I will talk to them on the Phone as their Therapist which then might trigger some level of Trust through already established “Therapeutic Alliance ” . Voice gives way to true Emotions and then only I can be with my patients therapeutically. Bottom up approaches through the Body like deep diaphragmatic Breathing , Visualization , Mindful Walking meditation etc etc etc.
    Patients or as you call them clients , don’t need a highly trained Therapist to tell them to light candles or burn essential oils and take warm baths .

    Reply
    • Allison Baird, CA says

      Youch! There is extensive research on treatment efficacy (even RCTs) on camera for communication and swallowing disorders. I believe having effective treatment accessible to everyone is a therapeutic obligation and treatment efficacy is only limited by ourselves. There is no need to be exaggerated on camera. As long as the patient can see and hear you, you are authentic, and your treatment is supported by evidence you can be confident that your patient will experience a treatment effect in person or on camera!

      Reply
  3. Lisa Lieberman, Psychotherapy, Lake Oswego, OR, USA says

    When I run into clients who feel guilty about complaining during this time, that they “should” feel grateful, I remind them that they don’t have to choose between gratitude and whatever painful emotion they are feeling.
    I frame it as “part of the landscape within their view”, i.e., when we are looking at a landscape, we choose to look at different parts of it at different times. Of course, if someone is only looking at the negative, painful aspects, then I delicately try to introduce gratitude into the conversation. If they are feeling guilty for complaining, again, I remind them about the vastness of the emotional landscape at a given time.

    Reply
    • Lisa Ndejuru, Psychotherapy, CA says

      Beautiful image and very helpful. Thank you.

      Reply
  4. Mary Kay Cocharo, Marriage/Family Therapy, Los Angeles, CA, USA says

    Thank you Bonnie. Well said. I have a couple who decided to build a little “office” out of an unused closet in their home for mom. We then had an online family meeting to talk about how she would use it and when so that the kids would fully understand her need for a bit of private alone time. The kids were so sweet about it once she found the courage to ask for what she needed. Again, I asked, is there a small part of you that feels deserving of a space of your own? We also traced it back to her childhood where she was always “in charge” of her siblings when her parents would get drunk and fight. Her “survival suit” demanded that she do do do and never relax. Once we were able to unlock that belief in her emotional brain, she was free to fully enjoy her little “office”. I believe she did add a candle I’m not so sure about the champagne!

    Reply
  5. Evangelia Andritsanou, Psychotherapy, GR says

    Fostering self-embrace has been my choice, too, in helping struggling moms during confinement. Self-embrace with satisfaction for the multi-tasking they were able to accomplish and self-embrace with compassion for whatever they were unable to manage. The latter not to be confused, however, with self-pity!

    Reply

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