Cars, Bathrooms and Closets:  Psychotherapy during Quarantine

Cars, Bathrooms and Closets:  Psychotherapy during Quarantine

by Kristin R. Krueger, Psychologist, Single-Mom

When we got our stay-at-home orders and the weight of it all sank in, I immediately went into action mode.  After all, I’m well schooled in responding to crisis and all that might go with a pandemic lock down.  First, I worked for years in our county hospital, putting in a number of ER shifts in a mental health capacity.  Seconds, I was raised by a father who spent his early years in post-WWII Europe and then lived a tenement-like existence in Chicago from 7-years-old through high school.  My mother was raised on a farm.  Long-story short, I know all about do-it-yourself, grow-it-yourself, reduce, reuse, reuse, reuse and recycle.  I’ve spent much of my adult life trying to not feel the weight of these lessons of my upbringing, but those skills are ingrained.  Third, I spent much of my 20’s living abroad teaching English, and thereby, picking up survival tricks here and there.  Finally, I’m an improviser, so I was ready, “Flexibility!” “Surrender to the ensemble!”  I thought, we would all have to change.  I want to be part of this solution.  Where do we start? I was built for this time – in which we have to use resources well, live with uncertainty, and work together. 

The mental health implications for medical front line workers were obvious early on and I wanted to and felt I should be a part of this.  I became obsessed with this idea.  So, I reached out to the coordinators for the physicians wellness program for which I work, and asked how I could help.  I signed up for the volunteer page for our state health department.  I even looked up the licensing process for New York State, which at the time was hardest hit.  “I have the skills!  I’m ready to help!” 

When I woke up from my ego-driven heroism fantasy, I settled into my reality.  I have a 4-year-old and was already struggling to watch her while working and attending to calls/conferences.  In between meetings, we baked, planted herbs, went biking and rode on the scooter.  We cooked 500 meals a day and washed 6,000 dishes.  She started virtual pre-K programing and I attended to internet and tech problems.  At times frustrations were high and my patience wore thin.  On one important phone call, I attempted three times to distract my daughter.   Embarrassed that I would have to ask the others to hold on a 4^th time, I silently grabbed a cupcake and pushed it towards her.   It worked.

And at the end of the day, my 80-year-old parents were my only viable option for childcare.  My other sitters had high-risk situations.  I hesitated due to not fully knowing the risks of us all being together early on.  Ultimately, we all quarantined together and have been healthy.  I initially used them sparingly – mainly to cover my time in telehealth psychotherapy sessions two days per week.  I was grateful to be able to work in some capacity.  To accept my reality, it helped to remind myself often what we learn as improvisers:  Your role is sometimes to not join a scene.  Not every scene needs you to walk on stage.   Having the success of the ensemble in mind helps you make the best decision for that scene.

I focused on treating my patients via telehealth.  Telehealth is awkward at first, but everyone learns to accommodate.  Because most patients live with others, they often seek out privacy in places, such as their cars, closets and bathrooms.  In one case the situation provided an opportunity for a visual so strong, that I was grateful for the closet setting.  This patient, with a history of OCD, was able to show me each of the 7 T-shirts – nicely folded and with a distinctive logo – that they had recently chosen to wear and then rejected because of an association with an obsessive thought.  ‘If I wear this one, my partner will get sick.  If I wear this one, something will happen to my friend., etc’

Some patients began the lock down with an increased sense of solidarity or enhanced motivation to address their anxieties.  The pandemic pushed them to dig deeper or it somehow put things into perspective for them – both resulting in better emotional management.  As the pandemic and lockdown have gone on, they express being weary – having good days and bad days – and increased anxiety.  In the most devastating situation thus far, I learned the following from a patient I see every two weeks.  In that 2-week interim, the spouse had gotten sick, received a COVID diagnosis, and died in the home.  My grief for this patient is tempered only by the beauty in the community’s response.  Since family members in the home have also tested positive for COVID, extended family and friends have gathered every evening to pray outside the home, which family members can watch from their window. 

So, what do we do with the pain, grief, weariness and uncertainty?  We do well to find the little joys in the changes.  The joys and benefits are there – if we are open to see them.  Sometimes we need to stop and create some joys – even when finding them is contrary to our productivity based mentality.  Embrace your creativity and know that doing so often comes with a limitation of our own or others judgment.  And as always, we do well to focus on the things that matter and allow the voices of criticism or dismissal – from yourself or others – to let go. 

As with any catastrophic change in a person’s life, acceptance of the situation and assimilation of it will help us act.  Acting gives us a sense of purpose and will likely move us forward in a positive direction.   We cannot and do not have to plan and predict to the extent we did in the past.  We can trade in a part of our competitiveness in exchange for enlarging our circle of compassion. 

I continue to be fascinated with this colossal world reset.  I’m curious and hopeful that a similar evolution in our ability to be inclusive of others will occur.  I believe the scientists will figure out a vaccine and human ingenuity will propel us towards a healthy economy.  I hope our city planners will help us learn how to thrive with a new social spacing structure.  And mainly, I look forward to an increased understanding of the importance of mental health.

When I picked up my daughter yesterday, I heard about the adventures of three mermaids that had to swim through the sea to find a treasure.  And these mermaids survived, found the treasure and then ate sweet rolls, ice cream, candy, donuts…

Note:  If a situation becomes overwhelming, then seek professional help!  Call 911 or go to the nearest emergency room if you have thoughts of hurting yourself or others.