How to make virtual therapy more comfortable?

Hi all,

I hope today is being kind to you.

I'm used to my therapist taking two weeks off over the summer, and then we resume.

Two weeks ago, she informed me that she's decided to go fully virtual for the six weeks of summer.

Last week, she also announced that she's decided to take her usual two week break as well...after which our sessions will be virtual until the 10th of September.

I negotiated a return to in person at that point because of World Suicide Prevention Day.

When we worked virtually over the lockdown period, it significantly changed the conversations we could have, and my capacity to have a conversation.

I found myself holding back on more emotional topics, because there's little point in paying somebody to watch you cry for an hour.

I'm already considering 'banning' the phrase "I'm right here", for obvious reasons...but I would be very interested to hear suggestions on other ways to make this experience more comfortable and less limiting.

Thanks,

Lost

I haven't done virtual therapy (my lockdown sessions were all phone only and very short, I've done the same thing for other absences, I followed the points below to some degree for those), but I still have a few general thoughts:
- if it's possible to set up something "shared", that'd be great. Like for example a scent she uses in her office, that she can take with her and you to your spot, so there's still something you both experience together at the same time. Or an object each of you can touch and show the camera.

- if possible make the spot always the same and have it be quiet and private.

- I usually like it to be as comfortable as possible, so for a whole session I'd probably surround myself with blankets, some comforting drink, stuffed animals...

I may come up with more later, and maybe you already do these, but:
--Hide your own image on the screen (I find it distracting, and it makes me self-conscious)

--Make the video call full screen

--Close programs that could have loud notifications pop up (like Facebook Messenger for me), as it can be distracting

--Come up with some sort of good-bye ritual (I never did this, but it might help), whether it's waving, each putting a hand to camera, saying certain words. Especially if it can relate to something you do in person

--Ask your T to have you be the one to leave the session--I used to hate how Dr. T would be there, then would suddenly vanish. If he was the one to leave the Zoom session, it could feel like he's just ready to be rid of me. So I asked him to let me be the one to click "Leave." Sometimes I'm like "Just give me one second," which happened when they updated Zoom and the button looked different. Or if I was really emotional. Because in person, I could wait a second to stand up.

These are just little things that helped me (aside from the good-bye ritual, which we tried a few times, like a little wave or putting hand up to camera or air handshake, then dropped, and I didn't want to push them).

I'm sorry you have to deal with this. Would it help at all to remind yourself that it's temporary? One of the most difficult things during the pandemic, both the early part, then when Delta hit after things seemed to go back to normal-ish briefly, was having no idea how long it would last. To think, "What if it just goes on this way forever?" So maybe if you can try to think "This is temporary, I'll see her in person Sept. 10," it could help? Even a sort of countdown, like "4 more virtual sessions."

Thanks, LT.

Last time R and I were working virtually, she had switched to Microsoft Teams.
This was incredibly challenging for me, as I hadn't used the program before, and couldn't figure out how to do 'the basics' (hiding my own image, etc.)

Didn't help that she could see me, but I could not see her.

I think the countdown would be helpful.

Thanks for the empathy...I feel like that's been missing in R's response to this.

Alright, she asked whether I wanted to know why she'd made the decision, but I said no.

Could be worth experimenting with me being the one to leave the meeting.

Our breathing practice emerged from the era of lockdown restrictions, so we'll still have that.

I appreciate your thoughtfulness.

Lost,
I'll pretty much echo CNS and LT's suggestions.

* Something shared: L bought us both cheap little candles. We light them usually together at sunset whenever there's something to grieve or something we're struggling with or even if we miss each other. After lightning and saying a blessing, we take a picture and send it to each other.
* We have also exchanged items. I gave L a bracelet and she gave me her blanket. We both always have our items with us during a virtual session. The only time she doesn't have the bracelet is when she's on vacation because she doesn't want to lose it.
* We have a welcome ritual. She asks what feelings are most present, scale of 1-10 for how I'm feeling, then check in questions about safety, sleep, smoking, and now rupture repair and then general updates. Then we talk.
* We also have a goodbye ritual for all our sessions. We start off with reassurances. When I'm done, I say okay. Then she says "me first or you first" for I love yous. I almost always say me. We say it to each other and then say okay. She tells me she appreciates me, I tell her thank you. She says goodbye first, then I do. I'm the one who gets to hang up. I absolutely hated her hanging up because it felt like she was cutting me off from her.

I'm still struggling with eye contact, so we're doing phone sessions on her virtual day. I don't like her seeing me on virtual, but I don't feel it fair that I get to look at her and she doesn't get to look at me.

Those are just the things that help me.

I love the role that ritual plays in your virtual sessions, Scarlet.

I get the impression that it also plays a role in your in-person sessions as well.

The candle aspect is something that I'm going to miss for the duration of this virtual experience ['Be polite, Lost']

Now wondering whether it's something I could ask her to do on her end.

Because me and fire don't mix, R usually lights the candle I have set up at the beginning of our sessions, and I'm the one to blow it out.

The setup of the space I'm in for virtual sessions would make it tough for me to have a candle around as well.

It's frustrating because the only reason this is happening is because of summer traffic.

We live in a popular place, and her area in particular is somewhere a lot of people go in the summer.

Oh! I forgot to mention Lost. "I'm right here" or "I'm here" pissed me off so much when L was on leave. And I told her. No she wasn't! She literally was not there where I needed her to be. In spirit is nice, but it's not being here. Maybe a better phrase would be "I'm there for you" as in "I support you". Even then, if she was really there for me she would make more of an effort. That's my opinion anyways.

Yes, our rituals are a crucial part of my relationship with L. Like we almost never diverge from it. We have a ritual for everything. Entering and exiting the building, too. We have rituals when I freeze. It can be annoying at times, but it also makes things safe.

Lost, I know it wouldn't be the same, but could you get one of those flameless candle things that turns on and off with a switch? And is it a scented candle? If so, maybe you could get some essential oil or something else in a similar scent.

That's one thing I forgot--I didn't continue this all through the virtual sessions, but I used to always put on a rollerball of a particular essential oil blend (it contained lavender, cedarwood, and...something) before in-person sessions. For a while during the pandemic, I'd put that on before the virtual sessions, so I could feel the connection through smell.

I also tended to still put on the rings and beaded bracelets (I used those as a fidget object) during my virtual sessions as I did in person (I still will generally put them on when we need to do virtual from time to time). Not sure if there's anything like that you associate with in-person, but things like that can help hold the connection.

And I *think* you do in-person therapy in your home, right? I may be wrong about that. So I'm not sure if you tended to dress any differently for that than if you were just generally hanging around at home. Or if you went to an office in person, if you dressed differently than you would at home. I tried to dress like I was going to therapy, rather than, say, having on PJs or really bummy clothes (if that's what you or anyone else wears to therapy, no judgment! I just know I wear different things if I'm sitting around the house and not seeing anyone beyond who I live with).

I've heard the same thing about doing professional Zoom meetings from home, to dress as you would to go to an in-person meeting, as it makes you feel more in that mode. Or even if it's a professional phone call without a video component, so no one would ever see you. And it may sound silly, but I also tend to brush my teeth before a Zoom session, as it makes me feel more...something!

It's kinda woowoo, but one of the things that L and I did when we were virtual was hold our hands up to our respective screens, palms forward, a connection of energy. Like I said, kinda woo, but it was helpful.

That's a brilliant idea, LT.

Still gives me the experience of the candle ritual, without the worry about fire.
You're right about the usual setting, although I don't tend to dress differently for therapy.

It's a heck of an adjustment, with a lot of baggage attached, even though it is temporary.

It was helpful to be able to have therapy during the pandemic, of course...but it was even more emotionally gruelling.

It's kind of mad that she doesn't seem to understand why I'm antsy about it - 'fear around particular emotions' doesn't really cover it.

Artie,

If that's woo, then what R and I do is another level.

We have a shared practice of sitting with our eyes closed and focusing on the third eye space (between the eyebrows).

This practice has helped me immensely in dealing with physical pain and the occasional anxiety flare up.

The sense of connection is the real 'issue' with working virtually, ironically.

I'm sorry I don't know this, but do you and your T ever touch.

This doesn't necessarily require touch, but it's something L and I do to get me back out of freeze. She calls it "falling out breathing". It's basically tensing your muscles plus breathing. You breathe in as much as you can and tighten every part of your body. You count to ten and let all the air out. And then you shake off (literally move/shake) of the energy. She said something like dogs do that to reset their energy? You can also focus the muscle tension on certain parts where you're holding the emotional pain.

L and I hold hands during this.

Thanks Scarlet,

Touch is a significant part of my work with R.
When what I am feeling gets too much, I reach for her hand...

Very hard not being able to do that.

Your exercise sounds like it would be useful - thank you.

Thanks LT,

I just remembered that a friend carved a pumpkin for me last Hallowe'en, and gave me a number of battery operated candles.

I still have one left over...so that will be very helpful.

Hope it helps some!

That’s not woo-woo! I do that with my T but instead of the whole hand it’s just the pointer finger…like in the movie ET.

I am quite the outlier here as I would never do another in person session after going virtual. (My health issues prevent me from leaving my bed but I won’t have a T come to me.)

My T and me are incredibly connected and I have never met her in person. We keep the connection by having an incredibly honest relationship. We talk about our relationship and feelings often. (But it does not consume our sessions.) She sent me a transitional object which also helps a lot. We have little rituals that we do each time, also. All those things add up.

Just answering here since it's more relevant ...

Oh this is interesting. Maybe there is some possibility for exploring the container itself. I find virtual work interesting (I experience the opposite to you in that my deepest work takes place online precisely because I feel safer in my own space and without another's physical presence) but have never really taken the time to explore what the virtual space is like. It's a strange place. I guess this would tie in with keeping the connection to your therapist, but also connecting with the space for what it is. So rather than bracing yourself and gritting your teeth through the virtual, maybe there could be some curiosity about it (ugh that's a horrid therapy cliche) and a way for you to expand into it.

I am interested in this for myself as well. Last session she made a comment about my energy coming into her home when we work online (I said this was not true, I didn't like the idea) and we referenced Mike Teavee from Willy Wonka. Where does the connection happen in virtual space because a connection does happen (albeit a different one from in person).

Your Mike Teevee reference made me smile - thank you.

We've had so much effing trouble with virtual sessions...the last time she could see me, but I couldn't see her.

There's no time for troubleshooting in that space, and I'm not in the best frame of mind for it.

For me, her physical presence is a key part of containment...which is lost (no pun intended) when we work virtually.

When she is physically with me, I don't feel like I'm holding quite so much.

Oh, the technical issue aspect really sucks. Is there an option for another platform if whatever she's using isn't working?

For example, one time when Zoom was having issues, Dr. T and I switched to Facetime (he uses that with some clients). Yes, it doesn't have the same safeguards in terms of privacy, I don't think, but it was OK. Not sure if that could be an option for you, though that may require both people to have Apple products. Something like Skype or whatever programs people use now maybe? Or Google Meets or maybe Microsoft teams? To be able to say "this isn't working" and have something else to switch to (that's already set up) that you both have ready?

Of course, if the issue is a bad WiFi or cell signal, that would be more difficult to solve (I've run into issues with that on occasion).