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Therapist Sets Realistic Mental Health Expectations for the Pandemic

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Mo headshot, a mental health therapist
Mo D,

“It’s okay, if nothing gets accomplished. It’s okay if you just have to sit there to make it through. It’s okay if you’ve gone back to behaviors you thought you never would have because you’re surviving.”

Mo is a doctor of psychology working at The Juniper Center. It is a great place, owned by a phenomenal business woman, and one of the first LGBT private practices in Chicago. Mo specializes in LGBTQIA+ issues, severe mental trauma, substance abuse, and eating disorders. They give client-centered therapy, which entails a collaborative approach to therapy to find what is most helpful and rewarding for their clients as their clients explore their inner selves.  Many of their clients are teenagers or young adults. That Mo is a younger mental health therapist – they became a doctor of psychology by the age of 30 – really helps them to connect with their clients. They are normally booked tight.

Mental health therapy is an essential service, and when the pandemic hit, the therapeutic community didn’t want to stop providing in-person sessions as many clients found the office a much safer place to talk about their issues than home. Since Mo had a lot of trauma cases, Mo tried to ride it out and was one of the last ones to stay on site. On March 16th, though, all the therapists were told to stop working from the office.

The work-from-home order precipitated a scramble to figure out how to make remote mental health therapy work. Teletherapy had never been supported by insurance companies, but there were no other options. Fortunately, they managed to get everything ready really fast. Consent forms were overhauled. Schedules were set. Within a month the company was back to staff meetings. Initially, about half of Mo’s caseload went to video or phone meetings. In the months since, though, Mo’s schedule has been filling up again. The majority of the therapy is still done remotely, but some clients have returned to face-to-face sessions, and there has also been an uptick in new clients who have had a lot of time over the pandemic to ponder personal issues.

The pandemic has impacted Mo’s clients. The clients seeking help now are spending more time discussing their mental health and how to manage their anxiety about society than they had before. The focus on their clients’ anxiety was also quite different than what Mo had expected. Instead of being anxious about getting sick, Mo’s clients, being younger, feared that they would get others sick. They worried that they might kill someone if they got sick – not just hurt. There was a huge escalation in their feeling of being responsible for the public’s safety, and they had to cope with the fact that others weren’t seeing it with the same seriousness.

Added to this was this pervasive feeling of isolation, which has affected everyone. In the beginning, everyone was thinking that they needed to be productive, like baking bread or getting fit, and not thinking that they needed anybody else. But with weeks and months passing by, isolation has taken its toll. The extroverts used to go out into the community and do things. This interaction was their coping mechanism. Now, they can’t. Those who worked outside forgot how much daily interaction came with normal jobs. When the jobs moved into their homes, they realized how much they missed those interactions. Even the introverts, who say they don’t need anyone, are feeling they need some type of connection. They’re seeing their friends drop away.

But months later, the pandemic is still here. The anxiety hasn’t left, and Mo is honest that they can’t fix it, but there is only so much anxiety our bodies can take before people start feeling defeated.

“The concept in psychology is this learned helplessness. We have nothing. We can’t go anywhere… We’re seeing anxiety turn more into depression now… Our bodies only remain anxious for so long until they realize nothing else is happening… Now to the hopelessness of people that kind of ride the line of why am I still doing anything I’m doing? Because it seems like there’s no light, especially like in the U.S. right now.”

Mo has seen depression increase across the board. They admit to their clients that there’s nothing that can be done. “I have to look at everyone and say, ‘It really pains me to look at you and say, I don’t know. I have no idea what we’re doing. I don’t know if we’ll be back [at the center].’”

Mo has also seen an uptick in substance abuse during the pandemic. It is a coping mechanism to deal with the helplessness. Some of their clients are feeling trapped. There is very little that they can do, and some are turning back to substance abuse. Mo accepts it.

I come from a harm reductive stance, which means I don’t expect my clients to ever be at zero. It seems unreasonable and especially unreasonable now. We have coping skills for a reason, whether they’re good or bad. And so [for] a lot of people whose substance use was their bad coping skill for a long time, well, it’s coming back.”

Suicidal ideation has also increased during the pandemic. Their clients are thinking more about what if they just disappeared. Living is hard, and they don’t have good coping skills, so they think about escape.

“If their family was getting on their nerves, they could go out or do something else or at least they came to therapy once a week and that was fine. Now it’s not. They’re trapped. And the only way their brain is, ‘Oh, you could just kill yourself. You won’t be in this situation anymore,’ because sometimes our brains are really just not logical whatsoever.”

Everybody’s getting caught up in their brains, and they can’t escape it. People have fewer coping skills and some have bad coping skills, but there’s nothing anybody can do.

I have to look at them and say, well, coping is better than being dead. So cool, I don’t want to change that.”

Mo discussed coping mechanisms with regards to society. Society as a whole needs to be gentler on themselves. This is a pandemic. Everyone’s mental health is being affected. Our animal brains are feeling that we are in danger. Our brains are absolutely panicking, and we are upset. We shouldn’t be expecting too much of people.

It’s okay if you’ve gone back to behaviors you thought you never would have because you’re surviving. That’s what we have to do right now. All of our brains are surviving… [I wish] more people in society could be like, oh, man, we have to be supportive. We have to be more gentle and kind instead of demonizing the fact that we are paralyzed as a society right now.”

Read more LGBTQ stories with how an event planner faces a perfect storm of apathy or how Patricia faced an LGBT legal quagmire where she was forced to divorce in order to adopt a child in Thailand.