In online counseling sessions, I haven’t seen nor heard any toilets. Not yet. But I have seen other things.

In psychotherapy, clients take us into their homes. When they show up they, in a sense, inviting us in their emotional homes.  Some more than others.  They show us the way around and ask our help because the trajectory of their home is in some way fractured and no longer working for them.

Today they take us into their homes even more. How often do I sit in session, like today, and John, who is talking about the lackluster sex in his marriage, whips out a photo of his wife and children. Or Jan who has just lost her mother and in deep grief and bereavement searches for a picture of her parents at their wedding 50 years ago.

Pictures in the office, via iPhone, iPad, or whatever device that accompanies them, is way more commonplace. Just the other day Emily showed me a picture online of what her new home, made out of containers, steel drums, will look like.

It is a technological world no doubt.

But with Covid-19 we have been let into their physical homes as well.  With shelter in place, therapy has resorted to telehealth—video platforms like zoom, doxy-me, or facetime or for some who can only show us a small bit, phone.

Much has been written of therapists’ experiences regarding sessions being interrupted by the family dog or cat, kids in the background, or that they had to answer the door for a delivery.

For many, these have been moments of a new exploration or often humor. How many of us have laughed at the glitches, random incoming texts, or alerts from CNN re the volatile stock market? Yet my interruptions have been limited.

Having just finished the NY Times piece by Lori Gottlieb, psychotherapist, on how the toilet has become the new therapy room and more, I wonder, have I been too rigid, staunch, stoic, controlling, or what? That I have emailed my clients, on more than one occasion, to assure that they continue to glean the most of our sessions by making sure that they create a safe and sacred space for them to have their sessions, and make sure that they have tissues and can mimic a space as close to the therapy container as possible. That they even take time before and after the session to contemplate our work (akin to the drive to and from) and that they not just hike back to check on the rib roast That said, not everyone has had privacy; with kids in online learning and the recent work from home status, and other family members joining to shelter in place for the period of time, it can get quite overwhelming.

I have been brought into bedrooms, living rooms, home offices, several lanais, cars, and even a closet but not yet any toilets. I have had house tours but have yet to meet other members of the family with one exception of having an opportunity to meet a spouse (actually the ex-spouse) and twice getting shots of grown kids.

In past moments the feeling of intrusion into someone’s personal space has occurred but with “time and repetition” (a therapy phrase) it too, like the work clients do, has softened. It has become more commonplace and I don’t feel as much a voyeur. Yet with telehealth, this experience is new and watching a client run from room to room to find privacy only to hide out in different parts of her (stately oversized) closet, albeit with one nearly intruder, was almost comical except for her emotional condition at the time; (she obviously didn’t get the email!).

Coming from a traditional medium practicing from the home, albeit with a firewall, is foreign to me yet from my understanding there were moments when some of the forefathers (Freud, Mahler, and such did sessions from their living rooms).

Although there are places in this country that lends itself to a working from home environment, we are not zoned for that where I work. Yet some of those spaces are separate and apart from the family space while some require a walkthrough. I myself have been to therapists where their office requires passage through the family space or access to it, something that notoriously engenders a feeling of intrusion. Although practicing from anywhere doesn’t set you immune to have what happened to therapist “Sue” in the latest season of Ozark; she not only practiced from her home but a central space with access to much of her living space.  (Regardless the cartel will get you anywhere).

My thoughts are, however, what about the clients? What do they really see? It’s not just about what we see and experience. We all show up a bit differently as well. I know there are therapists doing sessions from their living rooms and in some cases a designated bedroom or room with a fake screen, even their cars. I have had the opportunity to view the workspaces of colleagues. I am fortunate to have available to me a designated home office, detached somewhat (with separate entrance) from the main house pretty much (but not failsafe) indestructible to outside forces… no kids, dogs, and random visitors (although the landscapers have made a sighting from time to time). I wonder what our clients see, feel. and experience when allowed entry from the virtual waiting room into our personal spaces.  This is all curious to me and definitely grist for the mill when we return to (a new) normalcy.

What I have utterly enjoyed in a similar but different vein, has been to enter the spaces of those with whom I only know from a notable distance. Secretively I have been more interested in their backgrounds, their home décor, families, and personal touches more than in their performances, although those are a definite second best.  Watching the Elton John concert provided entry into his home as to the home of some others (some because Lady Gaga, a favorite, gave us a few walls a little personal reveals). (There is a huge difference between seeing home photos online, interior and exterior, and having the celebrity there simultaneously ‘living/ there. (It makes me wonder… do our clients google our homes as there are those online for public viewing if ever they were for sale!) We have seen some with their everyday garb, little makeup (certainly not professionally done) although Mariah Carey did weigh in with some heavy face paint. I saw the Lin Manuel Miranda surprise on John Krasinki’s show but when the participant numbers increased it was challenging to see more than the performer! And then there’s Jimmy Fallon and the huge number of talk show hosts and news reporters who air from their living rooms and some makeshift set.

Entering their space, clients that is, having been ‘forcefully’ invited in, has given me a new sense of closeness to them. I wonder what is in the mind of clients who too can become voyeurs? What is it like trying to access their emotions and inner states from a car? Given that our playing field is more normalized (we are both in our homes) how does that affect their relationship to us? I’m curious when we have a different view, our work-space back, how that will be.

For more information on Online Counseling with Dr. Winter read here.

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