Philip Chard's Out of My Mind column is sponsored by AllWriters' Workplace & Workshop, which offers online classes in all genres and abilities of creative writing, as well as coaching and editing services. You can read past columns here.
If you’re seeking counseling these days, the most viable option may be online sessions rather than the traditional face-to-face variety.
Most mental health providers have transitioned to video chat platforms, and this will likely continue until coronavirus testing becomes widespread. People sitting in a small office breathing recirculated air is a ticket for contagion, particularly in view of asymptomatic spread. A few treatment methods work best when done in-person, but until we know who is infectious, meeting face-to-face is a crap shoot.
The rapid transition to online therapy has proven taxing for some providers and clients alike. Granted, remote counseling removes the risks to one’s physical health, but mental well-being is another story. I’ve spoken with many colleagues feeling the strain from remotely assisting a steady stream of people beset by emotional distress due to the pandemic. Some clients tell me they find it awkward and less beneficial, as well.
“Telemental health care is better than nothing, but I worry about losing some of the emotional healing from being together,” one psychologist told me. “It feels like I’m working a lot harder to achieve that healing effect.”
“I didn’t anticipate how challenging it would be to work remotely,” one colleague remarked. “I’m so used to the physical presence of my clients and all the nuances you pick up from that. I guess that’s how many of us are feeling about physical distancing.”
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Demand is Up
Due to the pandemic, the demand for mental health services is skyrocketing. In some instances, calls to crisis hotlines are up 800 percent. Requests for telemental health care show similar upticks, which is an abrupt change many shrinks find disorienting. After all, most of us spent decades in face-to-face work. In a matter of weeks, online care went from occasional to predominant.
So, does it work? There is evidence psychotherapy via video chat is effective, if not ideal. For example, one reputable study found eye contact elicits similar empathic responses whether occurring online or in person, meaning a heartfelt healing connection is possible even when interacting remotely.
However, it proves challenging because being physically present provides what we humans evolved to prefer . . . primary interactions. Video chat relies heavily on visual and auditory inputs while excluding other sensory nuances, including elements of body language (most online visits show only the face and upper torso), and a kind of sixth sense called “gestalt presence.” This term refers to “an organized whole that is perceived as more than the sum of its parts.” This whole person experience makes it easier to grok (intuitively understand) the other individual.
Video chat creates interactions that offer a less than complete experience of another person’s presence. So, online psychotherapy requires more concerted effort to read a client’s mindset and emotions, meaning the absence of gestalt presence creates added mental strain for the therapist, and sometimes the client. Thankfully, we can ameliorate this conundrum by following a few guidelines, which prove applicable to online visits with friends and family as well as one’s counselor.
First, it helps to sit farther back from the screen so it’s not just two large faces staring at one another. This feels unnatural to humans, creating an “in your face” ambience that is off-putting.
Next, make eye contact variable, not constant. During in-person conversations, we rarely remain totally riveted on the other person’s eyes, but in video chat, we often do so to reassure folks we are paying attention.
Also, because this “pay constant attention” imperative drains one’s mental energy, it helps to take a brief timeout during the discussion, as well as not stack successive online visits too closely.
Finally, it’s more challenging to remain fully present during video chat, so remove potential distractions (e.g., smartphones) and do some deep breathing to promote mindfulness before, during and after a session.
We’re wired to be together in real space, not the cyber version, but presently, being together can be dangerous. So, for now, we’re fortunate online psychotherapy is even possible. Like many fallback options during the pandemic, it’s not optimal, but proves good enough.
For more, visit philipchard.com.
Philip Chard's Out of My Mind column is sponsored by AllWriters' Workplace & Workshop, which offers online classes in all genres and abilities of creative writing, as well as coaching and editing services. You can read past columns here.
