How are you? I hope you’re managing to keep your head above water these last tumultuous hours and days. This week on Fresh Dialogues, I have some reassuring wisdom and some practical tips to bring you comfort and help you keep hope alive.
Like millions of us, I watched in disbelief last night as many of the swing states turned red. The “blue wall” that some pundits anticipated –– and said Trump would pay for –– just didn’t materialize. I found myself in such a state of anxiety that I could barely breathe.
Frankly, I’m stunned that so many people voted for Trump despite his many atrocities: the blatant lies, his anti-science stance, demolishing environmental protections and his gross mishandling of the pandemic. And with the resurgence in Covid around the world, it sometimes feels there’s no end in sight to our elevated stress levels.
As I write this, early afternoon on Wednesday November 4th, the Associated Press has yet to call several key states, but there does look like a path to victory for Joe Biden and Kamala Harris. I can but hope.
How do you find hope at times like these?
If you’re also feeling high anxiety, despair, or even depression right now, this advice from a wise man named Manfred will give you hope.
“It’s so important right now to take care of yourself, and in that act of self-love and compassion you may be able to reach out to another, and that person another still, until we collectively heal from these challenging times,” Manfred Melcher.
As you’ll hear soon, Manfred reminds us to “Mind your own light.” You’ll find out what he means below.
My latest report for the BBC explored the timely question: Is online connection as effective as face to face meetings?
I explored the surge in teletherapy, but I think there are important lessons to be gleaned for all of us, whether you’re seeking to connect to friends, family or a mental health expert. I was reminded of the importance of radical self care.
My report aired October 28th on the BBC World Service program, Health Check. The segment starts at 28:00 on the BBC podcast
You’ll even find some humor in the report, despite the heavy topic. After the transcript below, I’ll share some tips to help you get through these next few days and weeks. And please join me at the end of the Fresh Dialogues podcast as we do some deep cleansing breaths together. You’ll be surprised at how stress relieving that can be.
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Here’s a transcript of the report (lengthened and edited for clarity). Names have been changed to protect people’s privacy.
The BBC’s Claudia Hammond: On the show last week, we were talking about the difficulty of patients and their relatives receiving bad news over the phone rather than in person due to restrictions in hospitals. Now something similar is happening in therapy sessions.
In the United States, a recent survey by the American Psychological Association found that due to the virus, three-quarters of therapists are now providing remote services, either on the phone, or through video conferencing software. But when people are pouring their hearts out and talking about their innermost thoughts, can a digital encounter ever be the same as a face to face session?
For Health Check, our reporter Alison van Diggelen reports from the west coast of the U.S. where, as well as the pandemic, people have been dealing with forest fires, choking smoke, and power cuts. The demand for mental health care is growing.
Alison van Diggelen: Kristin, lives alone in a beachside community in Southern California. She faced intense challenges before Covid struck. Recently divorced, she moved house and launched a new business last year. On top of her anxiety and panic attacks, there’s now another stress factor:
Kristin: Loneliness definitely has been an issue… not being able to see family: touching people, hugging people for four, five, six months. We weren’t built for that. Humans are built to connect. We have this innate need to connect with each other. Covid took that away. In order to protect each other, we had to disconnect. And find other ways to stay connected.
Alison van Diggelen: She saw an ad for the online therapy app Talk Space, featuring the Olympian swimmer, Michael Phelps.
Kristin: I did think: if he’s open to talking about it… I think people should talk about it more. We hire trainers to keep us physically fit all the time, and our mental health is just as important. That’s what a therapist is there for: to help us work on those issues which are just as hard, and if you don’t address them, it’s very dangerous. I said, there’s nothing to lose to try it.
Alison van Diggelen: Six hundred miles north, Arthur, a recent college grad, is adjusting to life back home with his parents and starting a new job in Northern California.
Arthur: All these feelings overwhelm you: mainly anxiety. depression, it’s been a tough time… especially family matters.
Alison van Diggelen: Even further north, Justin, a millennial, based in Washington State suffers from obsessive compulsive disorder (OCD) and depression. He obsesses about finding perfection and has regular compulsions to wash his hands.
Justin: One of my biggest triggers is unstructured time so when I started working remotely after Covid, it just really messed up my productivity and work habits. It became challenging to focus. I need a good separation of work and life…
Alison van Diggelen: When he visits his extended family, he faces even more triggers:
Justin: One of my family members triggers my intrusive thoughts, makes me feel invalidated.
Alison van Diggelen: Kristin, Arthur and Justin are some of the 50 million Americans with mental health issues. A 2017 study from the Substance Abuse and Mental Health Services Administration revealed that only 43% received treatment.
Of those who’ve managed to get help, since Covid struck, most are unable to meet with therapists in person and have begun using online platforms like zoom or similar technology to connect via video or audio.
But how does it compare to traditional, in-person therapy? Leslie Moreland is director of the Regional TeleMental Health Program at the San Diego Veterans Administration Health Care System. She cites peer-reviewed studies showing that video conferencing can be just as effective as face-to-face therapy for treating post-traumatic stress disorder, depression and anxiety. She says telehealth can help close the gaping needs gap.
Leslie Moreland: The studies have shown repeatedly that in terms of clinical efficacy, meaning symptom reduction, that the video conferencing modality is comparable, so you can achieve the same clinical outcomes, in terms of clinical effectiveness, feasibility and safety.
Alison van Diggelen: Moreland also examined what researchers call “therapeutic alliance” – which is when you feel comfortable with a therapist, that you can trust them, and that they attune to and validate your experience. Is it possible to establish all of that, when the patient and client aren’t even in the same room?
Leslie Moreland: The research has found that the therapeutic alliance is quite comparable, and is comparable enough that the benefit of the treatment still stays intact. Research has shown that patients do like to get therapy this way. More times than not, if you have the option to sit in the same room as someone, that’s often better, it feels more comfortable for folks.
Alison van Diggelen: Moreland believes that even before Covid, busy schedules, and juggling a family and a career, made teletherapy the only practical solution for many people, especially those living in remote areas.
For Kristin, saving time driving to and from therapy sessions was a huge advantage of moving from traditional therapy to teletherapy.
Kristin: Right away I felt connected, well taken care of. It was very professional. I liked the therapist I was matched with.
Alison van Diggelen: After a couple of video conferencing sessions with her new therapist, she used the texting feature exclusively.
Kristin: The technology of just having it on my phone. I liked that so much better than seeing a therapist at a certain time, and having all that stuff bottled up, writing it down in a journal. It was easier, if I was dealing with an issue or triggered by something, I could just take out the app and text her. I would get a response within two hours. I just LOVED that. It felt like having my own personal mental health trainer in my pocket.
Alison van Diggelen: Justin also likes the flexibility that teletherapy offers:
Justin: The best thing about teletherapy is the freedom to do it wherever I feel comfortable doing it. I like to pace a lot, move around when I do therapy. I like doing it outside. It’s nice to have fresh air. I get stuck in thought loops easily and therapy helps me parse out everything I’m thinking of sequentially. That helps me feel able to move forward.
Alison van Diggelen: But Leslie Moreland warns against treating therapy too casually – and has learned to set boundaries with clients. She’s even had to ask some to save that glass of wine or beer for after their session.
Leslie Moreland: There’s an informality that can influence the process… People get very casual, we have to remind them you need to wear a shirt … people are in the drive-through ordering food! If you don’t have anywhere in your room that’s safe, you can sit in the bathroom but we prefer otherwise.
Alison van Diggelen: Andrew finds technology glitches, rough connections and lagged responses can make the challenge of communicating with his male therapist harder.
Andrew: Some things are tougher to explain on Zoom. If he asks me a question, I have to find more words to convey the message. In a sense that facial expressions, body language and being able to read the tone of voice: It’s better in-person than on a call.
Alison van Diggelen: But he has learned some valuable life lessons from teletherapy:
Andrew: I used to feel I had to climb the whole mountain, it was just overwhelming. I realize the problem can be broken up into smaller chunks. You take each one by one….You don’t need to find the one answer to deal with the whole problem. It’s a process.
Alison van Diggelen: And how is teletherapy working for therapists? Manfred Melcher is a California based therapist with over 20 years of experience. He conducts about 70% of his therapy sessions online, but has mixed feelings about teletherapy.
Manfred Melcher: I notice if I do too many in a row, I get fatigued more than I do in in-person sessions. So much takes place in person with a client, the nuances of connection… While a video is quite good, it’s not the same. ..I try to do two in a row, then schedule someone who wants to come in in-person, or I’ll take a break. I try to do not more than 5 a day, that’s my limit.
Alison van Diggelen: He also cautions against the “app-ificaton” of mental health: the spike in online apps like Talk Space that offer text based therapy.
Manfred Melcher: We interact with technology with a lot of casualness….That could hurt people. I’d advise people to see apps in a realm of entertainment. They could contribute to your knowledge of psychology, understanding yourself emotionally, but the treatment… If you’re going to technology for treatment for a psychological issue, a medical issue: Woah! I’d be very cautious.
Alison van Diggelen: Experts predict that teletherapy is here to stay, except for severe cases of mental illness (like psychosis), where in-person therapy is vital. Most therapists and patients expect they’ll adopt a hybrid approach to therapy after the pandemic.
Therapist Manfred Melcher anticipates that the mental health crisis has yet to peak. Even he admits to moments of despair and finds the mantra “Mind your own light” sustains him.
Manfred Melcher: It’s so important right now to take care of yourself, and in that act of self-love and compassion you may be able to reach out to another, and that person another still, until we collectively heal from these challenging times.
That is my greatest hope… that we realize how connected the world is, and how dependent we are on each other. We are one human family in a deep relationship.
Our survival depends on each of us minding to our own light, and honoring the light of the other. And in lifting up the other, we lift up ourselves.
Alison van Diggelen: Justin, the young millennial dealing with depression in Washington gets a lot of the support he needs from teletherapy – but hopes to see his therapist regularly, in person, soon…..
Justin: I think everyone can benefit from therapy… it’s incredibly helpful and very grounding. For me it’s important to be face to face with someone. It makes me more comfortable and helps me focus better.
END of report
Simply put, we all need each other, and deep connection more than ever right now. But we must remember to first, mind our own light.
If there’s ever a time for radical self care, this is it dear friends. Do whatever nourishes you this week:
Have a cup of tea with an old friend,
Get outside for a walk in nature,
Sit on the sofa and give your pet some TLC,
And check out Maggie Smith’s latest book “Keep Moving“
And Oprah’s latest book picks.
Finally, I hope this breathing exercise will help you get through the next few challenging days. Here’s a handy video that helped me cope with last night. Many thanks to the team at The School of Self for making it.
If you’d like to try this breathing exercise, please turn off your phone, close your eyes and put one hand on your heart and one on your belly. Are sitting comfortably? Then we’ll begin…(Take three long, deep breaths: in for five…out for five, in for six…out for six, in for seven…out for seven).
Remember: Mind your own light, and then share it with others who need it right now…
Thanks again for reading and listening to Fresh Dialogues. I sincerely hope the next time we connect, we’ll all be breathing more easily.
Find out more about radical self care at Fresh Dialogues:
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