Many of psychotherapist Carol Robinson’s clients were doing well in early March, when COVID-19 was more of a distant concern than a reality. But now that their everyday lives are upside down, many are struggling.
Stay-at-home orders have turned parents into teachers and homes into offices. People whose work takes them into health care facilities and busy stores risk infection every day. Families are apart during birthdays, births and deaths. Robinson is starting to see the mental health of even well-functioning clients unravel. Their emotions run the gamut.
“Frustrated, angry, depressed,” Robinson said, of her clients. “Feeling trapped … because [they] cannot escape these unwanted feelings.”
Her clients, who once busied themselves meeting friends after work or with other activities, have fewer distractions to help them keep troubling emotions at bay. Some worry about being exposed to the coronavirus while also struggling with a lack of structure and uncertainty about the future. Many feel lethargic and unproductive.
“Clients who have jobs where they make decisions all the time — they’re very capable people — can’t organize life so that they can get the dishes washed,” Robinson said.
‘I’m basically terrified’
It’s not unusual for people to feel unmotivated when routines go out the window, said therapist Kristen Craren, who has an office in St. Louis County. The current climate of isolation is overwhelming for many who deal with anxiety and depression, because they often have a history of feeling they have no control.
“And right now, powerlessness and helplessness are just running rampant,” Craren said.
Craren’s new normal is working with adult clients the way she does with teenagers.
“Like, OK, we need to get up by 8 or 9 o'clock in the morning and brush your teeth and put something different than your pajamas on,” Craren said.
Like most therapists, Craren has switched nearly all of her clients to telehealth, or online sessions using apps like Zoom. That’s how she now sees her own therapist.
As are many of her patients, Craren is struggling emotionally — and financially. She’s lost half her income because half her clients have stopped therapy.
“Because they just don’t want to do telehealth, or because they have loss of income and can’t afford therapy,” Craren said. “And I’m basically terrified about what the future has to hold.”
Craren heeds her own advice about making and sticking to a schedule, for herself and her two children. Just as she advises her own clients, Craren makes sure to spend time outside her house.
“I tell myself, ‘You’re going to get up off the couch and you’re going for a walk, and you’re going to walk until your anxiety reduces,’” Craren said. “And so after about 30 minutes of brisk walking, I feel better.”
‘Get out there and man up’
Terrence Strong of Tower Grove East is also scared. He and his wife own a cleaning company and were already making their way through Chapter 13 bankruptcy before the pandemic. They haven’t worked in several weeks. To deal with his anxiety and stress, Strong writes and records songs. In one, he sings, “Don’t wanna feel bad, I’m searching for hope …”
But hope can be hard to find when the bills keep coming. Strong owes more than $800 to the bankruptcy trustee, $5,000 to the IRS, $550 to his landlord and nearly $600 to utility companies.
“It’s taken a toll on me, personally,” Strong said.
The pressure Strong feels has him thinking about fighting through his concerns. He wonders if he should go back to cleaning even though that would mean risking exposure to the coronavirus.
“There's like this voice in my head telling me that I'm going to have to get out there and man up, and not let the refrigerator get too low or not let the bills stack up too high,” Strong said.
On top of his financial woes, Strong is also dealing with the recent death of his nephew, who was shot and killed April 1. He’s grieving for the nephew and also worried about his brother and father, who lost a son and a grandson. Strong said he’d like to talk with someone but can’t afford to see a therapist.
“I feel numb. I’m having trouble thinking of a day when I actually felt good,” Strong said.
A big test
Strong and others may be able to benefit from free and low-cost therapy provided by several local organizations.
"People are starting to panic a little bit, and the longer we’re in this, the harder it’s going to be for everyone,” said Marsha Bradford, owner of Diversified Health and Wellness in Kirkwood, which offers therapy at little or no cost to those who need it.
Feeling overwhelmed and isolated can be particularly stressful for those who are addicted to alcohol and other substances. Even with online therapy sessions and recovery meetings up and running, it’s easy to fall back into old habits, said Aaron Laxton, development director at St. Louis’s Assisted Recovery Centers of America.
“It would feel natural to say: ‘I'm just going to drink myself into oblivion. I'm going to ‘use’ into oblivion, because that's what I've always done,’” Laxton said. “And so that's what we're really fighting against.”
Laxton, whose agency primarily helps clients with opioid addiction, has his own history of addiction and understands their plight on a personal level.
“We're not great at being alone with ourselves,” Laxton said.
The federal government has relaxed standards for addiction medications like suboxone, Laxton said. Patients can get the medications without having to go to a clinic, and they can take home larger quantities.
Sustaining recovery is still possible in the middle of a pandemic, Laxton said.
“This is simply a test of each person’s recovery,” Laxton said. “Although it’s a big test.”
Missing human touch
Some religious communities are ramping up their mental health outreach during the pandemic. Central Reform Congregation in the Central West End has expanded its monthly support group for people with diagnoses and their families to once-a-week gatherings.
The meetings are online, as are CRC’s weekly services, which are seeing a spike in attendance. Even so, Rabbi Susan Talve said the online interactions lack the warmth and camaraderie that people long for.
“We’re a very huggy, kissy congregation — and we can’t do that,” Talve said. “And we miss that.”
Before the pandemic, Talve paid regular visits to a CRC member in hospice, who can no longer sustain a conversation. She and the rest of the congregation made and sent a healing prayer tape, but that doesn’t take the place of being there.
“It breaks my heart not to be able to go and hold her, especially during this sacred, holy time in her life,” Talve said.
Craren also misses offering the occasional hug, handshake or high-five to her clients. She uses touch sparingly in her practice, and most often with teenagers.
“Human touch is very grounding,” Craren said.
Still, some of Craren’s clients are thriving with virtual therapy — and in their new home offices. Some find that working from home gives them more control over their daily schedule.
One hopeful outcome of being hunkered down at home is that Craren’s teenage clients, who’ve grown up with social media, are missing their offline interactions with friends.
“Our teens have been so plugged into their devices, and now they're getting this taste of how valuable human interaction really is,” Craren said. “And I think that's a rich lesson."
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