Copyright © 2020 Albuquerque Journal
There’s an old adage that “familiarity breeds contempt.”
That’s what many people describe when talking about the self-isolation imposed to stay safe from the COVID-19 coronavirus.
“They’re sheltering in place and getting on each other’s nerves because they’re not used to being together so much,” said Cathy Schueler, executive director of Bosque Mental Health.
“Those who can work from home seem to be having an easier time of it than those who lost their jobs and are now feeling the financial pinch. So they’re getting unemployment compensation, but it’s anxiety-producing and the longer this goes on, the more anxious people get,” she said.
On the other hand, despite the self-isolation and social distancing, “some are finding it a binding time to be with their families,” said Schueler, a licensed clinical social worker.
Fear of the virus is foremost on the minds of some patients receiving therapy from Samuel Roll, a psychologist and University of New Mexico professor emeritus of psychology.
“When they come for therapy they don’t have time to work on their own issues because they’re consumed by this overwhelming threat,” he said.
For these patients, “it’s difficult to get down to the therapy because they need time to discharge their anxiety and talk about the coronavirus.”
Some of his patients see the pandemic “as a vindictive act of God to punish human beings; others see it as Mother Earth punishing the human race for not taking care of her,” Roll said.
Whatever condition or dysfunction many of his patients sought therapy for in the first place, the COVID-19 crisis “magnifies and confirms it” in their own minds.
So what advice are people receiving in therapy to deal with the virus crisis?
“A lot of what we do is try to normalize this situation for people, letting them know you are not alone, we are all in this together,” Schueler said. “There’s a little bit of comfort in that as there is in reminding them that this won’t last forever, so just hang in there.”
One of the strategies used with clients is mindfulness, “being aware of your immediate environment, and knowing that all of this (self-isolation, social distancing and other safety measures) is happening for a reason.”
Another strategy is to slow down, take slow, deep breaths “and move yourself away from whatever it is that’s going on mentally, emotionally, and physically as much as you can.”
Roll also said he reminds patients that they are not alone in dealing with the crisis. He recommends that people get some exercise “and stay physically engaged.”
For people who have children in the home, his advice is provide structure, which “reduces anxiety.”
“Usually our time is arranged by work or school, so structure something for your children,” he said. “It doesn’t have to be school-related. It can be as simple as how many minutes everybody devotes to cleaning the house before you all sit down to watch television.”
Another issue is how mental health therapy is delivered, given the COVID-19 restrictions about social distancing.
Neal Bowen, director of the Behavioral Health Services Division of the New Mexico Human Services Department, said mental health services are essential services and that therapists – whether they are psychologists, social workers or professional counselors – can individually determine how to provide those services.
If they are seeing clients in person, “they must abide by the social distancing guidelines” announced by the governor, he said. The recommendation, however, is that they go to “remote” alternatives, such as telephone or audio-video conferencing, where possible.
“We also allow group remote therapy, and we’re hearing back that it’s very useful because people who are isolated in their homes get support from the other group members as well as the therapists,” Bowen said.
Schueler said Bosque Mental Health shut its doors to the public on March 11 and the 15 therapists working there are mostly using audio-video conferencing.
“We have telehealth embedded in our business software so that all of our therapists are able to do that from their homes.”
Initially, she said, there was some resistance from clients who said they’d rather wait until they could do face-to-face, in-person sessions again. Eventually, these people opted to try it and “we hand-walked them, so to speak, through the process before their session was to begin to make sure they knew how to set it up.”
Telehealth has been very successful and clients are finding they often prefer it because “they don’t have to leave home and don’t have to find a baby sitter, and they still get that one-on-one face-time,” Schueler said.
Roll provides some therapy over the telephone, but most of his patients are getting in-person service. Of seven people providing therapy in his office, he is the only one who sees patients in the office daily.
“Most patients prefer it, but for some it is essential because they had a lot of early depravation,” he said. “They have such a tenuous hold on the patient-therapist relationship, or any relationship, that they need the visual in-person contact for it to be nutritious.”
Roll does take precautions. Only one patient is allowed in at a time. He meets the patient at the door, which is immediately locked, and rather than sit in a waiting area, the patient goes straight to the room for the therapy session. Roll sits at least six feet apart from his patients, some of whom wear a face mask if they have concerns or anxiety that they may have been exposed to the virus. Finally, the office is sanitized daily.