Balancing Uncertainty and Adapting to Change: How We Live What We Teach Others

May 4, 2020

On March 9, 2020 during a clinical consultation meeting, I stated, “I don’t see the need to cancel in person client sessions yet, we will see how things look next week.” Two days later, I canceled all in-person client sessions and recommended others do the same, Coronavirus (COVID-19) was declared a global pandemic. In the span of two days, I went from “things can’t be that bad” to “things are really bad”. This vacillation of emotion continues for many of us. Uncertainty around how long this will last and what it will look like when we return to “normal” comes up a lot in the conversations I have and in my own thoughts. Whether you are working, not working, home with kids, not home with kids, social distancing, self-quarantining, or any other possible experience; it is not easy. We do not know how to feel, what to do, or how to cope. There is no reference point to draw from because this is new to all of us. 

We are striving to “create normalcy” in a time and space that is anything but normal.

As mental health providers at Anchored Hope Therapy, we have moved our ability to provide services online, via secured video tele-health therapy. We know that creating a sense of “normal” and “consistency” for our clients is important. We also know that social distancing, isolation, routine disruptions, high levels of stress, grief, and big changes can trigger past trauma symptoms, complicate current symptoms, or even create new and difficult to describe symptoms of anxiety and depression. We know that now more than ever people are struggling with adjusting to change on such a large scale that we will not truly know the physical, emotional, and mental impact of our current state of heightened anxiety for years to come.

As a team of collaborative, trauma-specific providers, we have been trained to acknowledge struggle for both our clients and for ourselves as providers.  Acknowledging our own struggles supports our sustainability to care for ourselves and to continue to be supportive to others.

Self-reflection and self-awareness skills allow providers to acknowledge and move through their own reactions to the work, to stress, and to external factors, in order to maintain a clear and balanced presence for their clients.

We are therapists AND we are also managing our own homes, figuring out ways to obtain needed groceries, and social distancing while maintaining relationships with family and friends. We are striving to stay present and feel productive while simultaneously preparing to give birth, caring for infants and toddlers, and/or home-schooling our children as well as generally trying to maintain positive physical and mental health in order to continue providing quality mental health services to our clients.

This is a marathon, not a sprint.

We are sharing these thoughts with you to allow you insight into our process. We are here, we want to be here, and will continue to be here for you. This level of presence and commitment takes work. You are not alone. 

We know that making changes in therapy is hard. We know that trying to do something your brain and body are telling you not to do is hard. We know that breaking patterns of behavior that no longer serve you is hard. We know this because we do this work too, every day, in order to continue to be a provider that can sustainably keep helping. We know that the burnout rate in helping professionals like us is high. We know that changing providers and finding someone new is not fun. We know that retelling your story all over is frustrating. We hold these things in our awareness and know that taking care of ourselves AND doing the hard work too is necessary. Below you will find what some of our providers are experiencing, noticing, and reflecting on during these challenging times. Again, we believe in sharing our process with you. We believe in acknowledging that adapting to change is HARD and we are adapting right alongside you. You are not alone.  When we say “be patient with yourself” we also know that to be true for ourselves.  

“It’s been 7 weeks of seeing clients virtually and I’m still learning to navigate all of the professional and personal changes this transition has brought. As a therapist who has never used tele-health before, I felt both at peace and terrified with this new reality. At peace because there were no alternatives. Terrified because I worried significantly about how this new platform would affect my clients, my ability to provide the same quality of care, and the therapeutic process in general. What I have found is that as humans we are incredibly adaptable. Nothing can ever replace the connectedness, safety, and bandwidth free experience that in-person therapy provides, and in many ways tele-therapy has allowed for a different kind of personal and therapeutic connection. I look forward to returning to my office and sharing space with my clients once again, and in the meantime, I continue to value the completely unique experience of navigating a pandemic side by side with my clients.”  

Emily Young, LMSW

“I truly miss the in person connection of seeing my clients in my office and look forward to a time when we can be together again. I look forward to ending each session as I usually do, with misting clients with an essential oil lavender or sage spray and asking them to feel a moment of peace. We’re all doing our best to adapt to a new normal, myself included. I know that this pandemic, and the multitude of ways that it has currently impacted all of us, is both stressful and anxiety producing. I am so grateful to my clients, for their courage in joining me on telehealth, and continuing to let me walk beside them during this crazy time. I’m adding in more mindfulness, relaxing breathing and sometimes gentle yoga postures to my sessions, and observing that this is helping to bring some bit of calm and space for some. I’m encouraging all of my clients to practice lots and lots of self-care and self-compassion, as well as managing their expectations of themselves during this challenging time. I know we will all get through this together! And this quote from the Buddha brings me comfort: “You, yourself, as much as anybody in the entire universe, deserve your love and affection.”

Ruth Milsten, LCSW-C

“Tele-Health was not a platform I ever saw myself utilizing as a mental health clinician. Enter COVID-19. When we are presented with a challenge, we often find ourselves growing in ways we never thought possible. Traumatic growth is very real, especially now, not only for our clients, but for us as clinicians as well. I genuinely miss connecting with my clients in person and hope that eventually we can return to a time when it is safe to do so again. In the meantime, I remind myself that although so much has changed, one thing has not. I am still present for my clients and learning how to cope with uncertainty right along side them. I am taking the opportunity during this intensely challenging time to learn more about a modality of treatment that I never gave a second thought to before. What I am finding out is that I kind of like it. It has its pros and cons, like most things AND it’s what we can do right now to continue providing quality clinical care to those we serve. I remind myself to honor the emotions that come up, allow them to reside next to me for a little while, thank them, and then let them go. Because we are human…and being human is often challenging…and challenges yield growth.”

Christine Coyle, LCSW-C

“Like many others, the unexpected changes in our world as a result of the COVID-19 pandemic took me by surprise, causing feelings of uncertainty, loss, anxiety and doubt. Suddenly, we found our routines disrupted and many things that brought a sense of calm and comfort have not been available. Perhaps more than ever, we need to rely on connection and communication to promote feelings of well-being, security and calm. We are adjusting to connecting in different ways. We are using FaceTime and Zoom, attending classes online, and connecting with loved ones over the phone. We are having game nights and story times over video and are celebrating exciting milestones from afar.

I have always valued face-to-face interactions and as a therapist offering teletherapy during the pandemic, I wondered how I and my clients would adjust to this new modality. Throughout this process, I have been struck by resiliency and adaptability. It is hard to adjust to new circumstances while grieving the absence of routines that provided comfort and normalcy in the past. Despite the challenges, however, every time I connect with a client via telehealth, we are able to celebrate that connection. We celebrate that we have the technology that allows us to interact and we celebrate our ability to adapt our routines to the online environment. We celebrate the creative ways clients are connecting with others in their lives and we brainstorm even more ways to connect. We seek normalcy through connection and, in doing so, aim to maintain our relationships and communities. We recognize how hard this can be yet how important it is. I am proud to be a member of the Anchored Hope Therapy team, which is striving to maintain connection in uncertain times.”

Kendall Patterson, LCPC

“The concept of “this doesn’t match the picture in my head” is universally striking a chord right now. Our world, Spring 2020, weddings, graduations, family traditions, and how we provide and receive support–none of these are looking like what we had hoped and expected. Alongside my clients, the wonder of creativity, resilience, and flexibility have emerged. I am profoundly appreciative of sharing this experience with them. Not only have adults, teens, and children been able to meet the challenges of having our norms turned upside down (and done so with remarkable grace), our sessions themselves have given new meaning to thinking outside the box. Did I foresee telehealth family sessions to look like parents, children, and the family dog in bunk beds? No. Did I expect to witness DBT skills in action via impromptu MC Hammer dance party breaks? No. Do I love it? A resounding YES! My love of what I do continues to flourish, and to my clients I say a sincere thank you!” 

Victoria Ringo, LCSW-C 

“My last “in person” session was in a field across from our practice, in lawn chairs, six feet apart.  We practiced mindfulness by spending a few minutes gazing at the sky, and then a separate stint finding the perfect weed and examining every facet of it.  And then, that ended too, and tele-health became the new norm. I wholeheartedly promote breaking up homeostasis, allowing a paradigm shift, adopting a new norm, welcoming change.  But, Corona, oh no!  I had to adjust in several areas.  So did my clients.  And now we meet on a screen.  But the thing is, connection, insights, unloading and planning for the new (even if that is who knows when in the future) does not stop.  So therapy has not stopped.  And we grow.  As I type I hear the spring rains outside. Roses will bloom, sprouts will break through, lettuces will unfurl, squirrels will leap and birds will chirp.  And so our own movements, forward and through, will reap a birth of newness, reaching out to experience the sunshine of life regardless of the turmoil around us.  Stay grounded, hope for better, but appreciate the NOW, and remember that even in the darkness with a storm raging, seeds change, blossom and bloom, as will precious YOU!”

Susie Cooper, LCPC

“What a time to be alive. We are individually and collectively having to confront what it feels like to come to a stop in our lives, without choice. This process is painful, it can be re-traumatizing and it can feel dangerous. The people with whom I work with are grieving the loss of ideals, plans, expectations and uncertainty. Yet, uncertainty is a necessary component to accessing vulnerability, which is the greatest marker for courage. Brené Brown says uncertainty, risk, and emotional exposure are the measures of vulnerability and that we cannot be courageous without being vulnerable. 

So here we all are, vulnerable and courageous as ever. In order to show up fully for others right now, I find myself outside, a lot. Everyday I try to put my bare feet on the earth. I remember to breathe, and I try to listen. When I feel vulnerable, my first instinct is typically to grasp for control. But if I don’t react on that initial impulse, the next one is often to observe, notice, and get curious about the world outside of myself. Here, I remember how deeply interconnected we are to one another, to sentient beings, and to our collective home. 

As a therapist I have held onto a mantra during this time that keeps me grounded. Dr. Gabor Maté said in a recent podcast interview that “a crisis is the combination of danger and opportunity.” This has been a human crisis on so many levels. But what if there is also a tremendous opportunity here? 

As a result of our collective forced stop, we are seeing positive shifts in nature. Previously smog ridden cities are clear with stars at night. Snow-capped peaks in the Himalayas are visible from long distances for the first time in decades. Black bears in Yosemite National Park are feeling more comfortable to graze spring grasses and take up space in their wild homes. As we have taken a step back, the natural world is getting a much needed pause to reclaim its habitat. And we are being invited as humble witnesses to this process of earth’s reclamation.

My greatest hope is that we will learn to commune with nature and with one another in a new way. That it is not human vs. nature but human and nature that works best. That we will change the pace and the focus of our lives. And that we will rely less on comparison, and more on presence, connection and curiosity. And finally that my clients remember how strong they are, because it takes a resilient person to be alive right now.” 

Laura Marques Brown, Nature Therapist, LGPC

“I am not a fan of change and thrive in a routine. I am sure that most of my clients would agree that anything that upsets the “normal” creates a downward spiral of fear, hopelessness, and anxiety. Not only has our “normal” been interrupted, but there is no end date in sight. There is no training that can adequately prepare a therapist for a pandemic. I am learning on the fly, as this is not only a first for me but a first for my clients as well. I have been amazed and humbled by how quickly my clients have adapted to this change and how much we are all learning from each other during this time. 

Telehealth is not something I thought would be a part of my practice, but I am thankful that I am still able to connect and support my clients through this new “normal.” We are all learning how to be kinder to ourselves during this time, something that I hope becomes part of our new “normal” when this is over.”

Megan Yount, LCSW-C

“On Friday March 13th, I was finishing up a two day evidenced-based trauma training in Silver Spring; uncertainty filled the air as news of COVID-19 was ramping up and schools were closing down. I made my way into work that following Monday for my first Telehealth sessions, and before the day was half-way over, updates were coming in from Governor Hogan and I decided to pack up everything I’d need to work from home starting the following day. It felt strange, straight from an episode of The Twilight Zone, and I wondered if I was “overreacting;” yet there I was the next morning, set up in my guest room/office with a make-shift therapy space. And here I sit, 7 weeks later (or is it 67 weeks later? sometimes it feels that way), with the same work from home routine and a slightly less make-shifty therapy space. 

On that first Monday, providing the first Telehealth sessions, I held my own reservations and anxiety at bay to allow myself to consciously show up for my clients. What would it be like? Would the same connection and warmth that I strive for in my office translate sufficiently over video? Would my clients be on board? Session by session, I was greeted with reassurance – it seemed that not much was being lost in translation. Clients bravely showed up for sessions in this unfamiliar format, during these uncertain times, and talked freely about their own uncertainties. Real therapy was happening – and at a time when it’s really needed. 

“It’s not a terrible thing that we feel fear when faced with the unknown. It is part of being alive, something we all share.”

~ Pema Chodron

Providing Telehealth from home for me has meant: support from my husband (who is balancing his own job, and parenting and homeschooling, while I am closed away in sessions to maintain the same type of confidentiality that would be offered in my “real” office) and patience from my two young kids (who have had to shift their understanding that mommy going to work now means mommy going upstairs, locked in her office where she cannot be disturbed). It means hearing and validating clients’ stories of COVID-related death and loss (loss of so many varieties), stress, isolation, and the intensified reality of juggling 27 plates in the air at the same time. It means holding space for my clients as they process all the things that COVID-19 means to them, while also going through the same storm with them, [mostly] outside of our sessions, as a fellow human (although as I have acknowledged to so many of them, we are not all in the same boat as we weather this collective storm). It also means, for clients who are able or inclined, to continue to work on pre-existing therapy goals in the midst of a pandemic. It means helping clients, and myself, slow down to feel, notice strength, practice self-care, and connect with others in ways that are possible under the current circumstances. It means tolerating my own uncertainty while navigating, and supporting others, through something so unfamiliar and nerve wracking. In many ways, this means not having answers – and while therapists don’t always have the answers, in this particular situation it feels different, harder. 

In reflecting on all of this, I realize that the answers have actually been: warmth, validation, connection, a space free of judgment, meeting each client where they are, and more than ever, being a human who also happens to be a therapist. So really – the answers have been to hold on tightly to the essential, foundational basics of what it means to be a therapist. I’m not an omniscient being with all the answers, I’m not a wizard with a magic wand, and I’m not a healer who will remove all of your very valid pain. But I am a therapist, and I am a human, and I am committed to holding this space with you as we navigate this uncertain time that will most certainly go down in the histories of our individual and collective life stories.”

Caitlin Heffernan, LCSW-C, Therapist

“COVID-19 has brought not only illness, pain, loss and confusion, it has also forced us to acknowledge and examine our own fears, anxieties and weaknesses…and summon the personal courage to push beyond.  As a therapist, it is a privilege and honor to walk beside my clients as they learn to move through this process.  During this crisis pandemic, I, too, am facing my fears and learning to push through, which has been difficult and at times disorienting.

When the Stay-At-Home order was first imposed, I wondered and worried about my therapeutic abilities and how they might be diluted or even erased using a computer to “meet my clients virtually”.  How would I make the essential connections necessary to help them feel safe, heard, and supported?  What if I couldn’t dial in to their needs in the same way, particularly with my youngest clients for whom therapy is often comprised of tactile sensory mediums like crayons, puppets and games of Uno?  What if our sessions were boring or uninspired?  And how would I ever be able to stop staring at my own talking head in that little box in the corner of my screen, watching myself do my job while wondering, “Is that what I REALLY look like?”  I’ll admit, the whole thing seemed pretty daunting.

And so I began using our tele-health platform out of necessity but with trepidation, doubt and a healthy dose of skepticism.  At first, I felt stiff and nervous and more than a little distracted by my shaggy hair in dire need of a highlight, not to mention the computer glitches and screen freezes and near-constant nagging worry one of the newly-homeschooling teenagers in my own house might inadvertently burst into the bedroom asking for a snack.  I felt awkward and highly self-aware.  

I soon began to relax, however, as I realized the relationships with my clients still exist across the digital space between us. The magic of therapy is often found in the context of the relationship itself, and thankfully, as it turns out, the substance of those relationships with my clients has not changed, even though my current professional venue has shifted from my office (with its tools and trinkets and fidgets and games) to my home, my laptop and my own ingenuity.  

A slogan – a therapeutic mantra of sorts – began to evolve during my online sessions, as one client after another shared difficulties being and staying at home…experiencing loss and angst and fear and worry…wondering and worrying about the future.  I forgot about the computer screen, relaxed into the space, and began reminding my clients (and myself) there is no “right way” to cope with a pandemic.  There is no “right way” to manage the overwhelming uncertainty we currently face.  We have adjusted and readjusted and adjusted again.  So much change.  So many unanswered questions.  We sit awkwardly, suspended in the balance between our lives before and our as yet unknown life-after-the-virus normal.  

How can we know what the coming weeks and months will bring?  How should we respond?  How do we balance the needs of our communities, our nation, and perhaps our world, against those of our own families, our livelihoods, and our own sanity?  How do we manage our anxiety when faced with such an unprecedented interruption into life as we’ve known it?  What, exactly, is required at this moment?  

Of course, I don’t know the answers to these and the thousands of other questions punctuating the quiet.  And the truth is, we really cannot do anything but wait. And wonder.  And hold space for ourselves and those we care about.  We have to, in effect, press our collective “pause” button right now.  Press “pause” on the guilt.  Press “pause” on the shame.  Press “pause” on all the “shoulds” that so often drive us forward even as they nag at us that we secretly aren’t good enough.

And so my mantra – across the tele-health universe between me and my clients’ homes (and cars, and backyards, and wherever they choose to share space with me in this moment), has become simply this: 

Do what you can.  Be still, and calm, and honest, and brave.  Be real, and open, and sad, and afraid.  Be confident, and gentle, and intentional.  Be all of it, with no guilt, no shame, and no shoulds.   And so we keep at it…we keep talking and sharing and working out the pain across the digital landscape…and we remind ourselves over and over again – together – no guilt, no shame and no shoulds.

And so I have discovered the tele-health platform does not actually divide us but simply provides another mechanism to meet, share and engage in a different but equally impactful way.  We are yearning for support, connection and meaning more than ever right now, and if we cannot be together in person, we will share togetherness in other ways.  Until we can physically be together again, this telehealth experience will help us hold space.  Together.  With no guilt, no shame, and no shoulds.”

Christa Bellanca, LMSW