By Annabelle Parr

During this incredibly stressful time of COVID-19, we are having to make major life adjustments. With the new shelter in place restrictions, you might wonder whether psychotherapy is still an option available to you. The short answer is yes!

Telehealth, also known as video conferencing or online therapy, has been available long before COVID-19, and is an important alternative to in person care.

Traditionally, therapy is done in person. However, with the emergence of new technologies, there have been an increasing number of telehealth / video conferencing options and platforms emerging and available in the mental health field over the last decade. This means that not only do we have the infrastructure available to offer confidential, HIPAA compliant virtual therapy, but also that there is already plenty of research on telehealth and its efficacy in mental health treatment.

Prior to coronavirus, teletherapy expanded access to care to individuals who were not able to get to a therapist’s office, whether that was due to scheduling difficulties or a lack of mental health care options in their community. Now, shelter in place poses a barrier to accessing in person care for all of us. Thus, telehealth via video conferencing offers convenient access to care for everyone as we are required to stay at home as much as possible.

How effective is telemental health care?

According to the Anxiety and Depression Association of America, “from a large body of research we know that telemental health leads to high patient and provider satisfaction ratings and achieves health outcomes equivalent to in-person care across all diagnostic groups” (Yellowlees, 2020). So as long as the client is willing to engage in therapy virtually and is not an extreme risk to themselves or others, research shows that telemental health is as effective as in person treatment.

How does virtual therapy work?

Typically, telehealth involves video conferencing with your therapist using a secure, HIPAA compliant platform. No extra equipment or complicated applications are required. Clients can use their smartphones or a laptop computer with a built-in camera. Therapists are able to offer telehealth services to patients located in the state in which they are licensed. So a therapist licensed in and practicing in California is able to offer teletherapy services to patients located in the state of California. Though not all therapists were offering telehealth options prior to COVID-19, given the current situation, many have adjusted their practices to offer video counseling options to patients in need.

What should you look for in a telehealth provider?

The same things you would look for in a therapist you would see in person: you want to ensure that the therapist you choose has expertise in the areas in which you are seeking treatment for, and you want to make sure the therapist feels like a good fit for you personally. One thing we know for sure is that the quality of the therapist-client relationship is the most important factor in producing successful treatment outcomes across settings, in-person or online. This means that in order for therapy to be effective, you have to have a solid trusting rapport with your therapist. Assuming those two conditions are present, telehealth is likely to be just as effective as working with the same therapist in person.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness, and Telemental Health Services. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.

by Annabelle Parr

One of the many challenges presented by COVID-19 is the way it has altered how we are permitted to relate to one another. Required to maintain distance between ourselves and others, we are allowed out of our homes only for essential business and errands, or to take walks or runs as long as we keep at least six feet between ourselves and those we pass. Initially this six feet rule was termed “social distancing,” but experts have proposed that we shift our terminology to “physical distancing.” While this may seem like a trivial shift, it speaks to the importance of relational connection and reminds us that we must keep a physical distance from one another, not an emotional one.

Humans are inherently social creatures; we evolved in a context that dictated that connection and cooperation with the group was vital to our survival. So what a strange situation we find ourselves in where, for our collective wellbeing, we must put physical distance between ourselves and others. Paradoxically, you may find that this new paradigm is helping you to reconnect with friends and loved ones you rarely spoke with prior, taking advantage of the technologies that allow us to see one another even when you are not in the same room, city, or even country. You may also be finding that this shift has thrown new, challenging, unprecedented and unexpected variables into your romantic relationship. Whether you are dating, in a committed relationship, or married, COVID-19 has altered our daily lives in such a way that it is bound to impact our relational lives.

Dating during coronavirus

If you were dating prior to the COVID-19 outbreak, it may feel difficult to know how to proceed. With so many options for online dating and dating apps, the dating landscape has changed dramatically over the last decade, even prior to coronavirus. However, while these apps may help you find and connect with people you wouldn’t otherwise meet, typically, the dating itself has still involved actually meeting in person. For the time being, meeting in person is not an option.

But what if you are still interested in dating, meeting new people, and pursuing connection? If it is important to you to continue dating during this time, there are options available to you if you are willing to be flexible and creative. Rather than going out on dates, you can opt for talking on the phone, setting up a video call happy hour, or even a Netflix Party to share in a favorite TV show or movie together.

It’s also important to know that there is no pressure. If meeting for the first time through your computer screen does not sound like something that is in line with your values at this moment in time, that’s okay. Give yourself permission to take a break and know that this is temporary. Tune in to what matters to you and what you need to do to take care of yourself during this time.

Relationships during coronavirus

Maybe you are already in a committed relationship. If you do not live with your partner, you may have found that suddenly it feels like you are in a long distance relationship. Depending on any number of variables (from whether you or your partner lives with others, whether their roommates are still working outside the home, etc.), you may not be able to see each other or connect using any form of physical touch right now.

If, on the other hand, you are living together or have chosen to quarantine together, you are likely now spending near 24/7 in the same space together. This can present its own set of challenges. As much as we love our partners, as relationship expert Esther Perel noted, “our need for togetherness exists alongside our need for separateness.” And it can be hard to find that separateness during shelter in place.

Marriage and/or children during coronavirus

If you are married and/or raising children with your partner, not only are you and your partner now together 24/7, but the kids are home as well. Trying to navigate working from home and homeschooling children on top of everything else presents a lot of new variables to manage as a couple and family.

Tips for tending to your relationship during coronavirus

Whether coronavirus has meant that you and your partner cannot see each other in person, or whether it means that you are now almost constantly together, connection and communication are crucial for navigating this time together. Here are some tips for maintaining a loving, balanced relationship during COVID-19:

Acknowledge and have self-compassion for your emotions. Allow yourself to have your feelings. Be gentle with yourself and know that however you are feeling is okay. When we are willing to have our feelings and to be compassionate to ourselves in the midst of pain and struggle, we are able to make deliberate choices about how we communicate and behave that are in line with the type of person and partner we want to be. When we are unwilling to have our feelings, or we are unkind to ourselves, our emotions may find unhelpful ways of leaking out and may come to covertly control our reactions.
Clearly state your feelings and your needs. Our partners are not mind readers, nor should they be. We are all individuals with unique feelings and needs, and we can best support each other when we are each clear about what helps us to feel safe and loved. I-statements provide a useful template for communicating your feelings and needs clearly (I feel [x] when [y], and I need [z]).
Give your partner space and compassion to process and experience their emotions. Know that it’s totally normal for each of us to feel and think differently about this situation. You and your partner may have different needs, feelings, and opinions, and just as it is important that you allow yourself to have your experience, it’s important that your partner has the space to have their experience as well. In any given moment, one of you may feel anxious about all the uncertainty, while the other may feel grateful for time to slow down; one of you may want to be productive, while the other may be exhausted. One of you may want to be as informed as possible and process the information aloud, while the other may want to watch Netflix and only update as necessary.
Work together to creatively support each other. You may have different needs during all of this, and that can be hard to manage. Carve out time to meet each other’s needs and find ways to compromise. For example, those in long distance scenarios may find one partner is craving a FaceTime date, while the other wants to ditch their screens for a while having been glued to them all day while telecommuting. Plan a time for a screen date to maintain connection, and also plan out some time for a screen detox.
Stay connected with friends and family. Romantic relationships are not meant to function like islands; yet when we are stuck in the same space for weeks on end, it can start to feel like we are literally stuck on an island together. Make sure to reach out for support and connection with friends and family during this time. Having a wider net for support in times of stress is crucial.
Strike a balance between connection and separation. If you are in a long distance scenario, you may be craving more connection. If you are quarantining together, you may be craving more separateness. (Though of course the reverse can be true in either scenario as well). It is important to find time to connect, share our emotions, needs, and experiences, and be together, and it is equally important to have some space to ourselves, to read or engage in personally enjoyed activities, or catch up with other loved ones. Being intentional with our time and space, and honoring our own and our partner’s need for both connection and separateness can help us to strike a balance.
Laugh together. Humor can be so healing during times of stress. Finding things to laugh about together can help us bond and help defuse some of the tension we may be feeling. Whether this involves watching funny videos or shows together, playing silly games, or just finding the humor in little moments, laughter really is good medicine. It might sound hard to laugh during such a stressful time, but it’s important to seek out something that brings us a little joy and levity.
Connect with gratitude. This does not mean you are not allowed to feel anxious or sad or angry or exhausted about this massive upheaval. However, pausing to mindfully appreciate small joys or victories can help shift our perspective, even if just for a moment, and can help us to weather the storm with more resilience. See if you can notice the things that you are grateful for in your partner, the little moments with them that you cherish. Try to connect with something you are grateful for each day, whether it has to do with your relationship or not.
Utilize the tools available to you. We are still able to go outside, breathe in fresh air, take walks or go on a run. And thankfully we live in a time in which we have a whole host of technology available to us that allows us to stay connected in ways never before possible. None of this is an ideal situation, but don’t forget to utilize what is available to you to help create balance in your life and relationship where possible.
Seek professional support. If you are experiencing stress, anxiety, trauma, or depression that is impacting your ability to function effectively in your relationship (or any other important area of your life), professional support is available. Many therapists, including Dr. Shea, are offering telehealth services to clients during shelter in place. Telehealth or teletherapy typically involves conducting sessions via a videoconferencing platform or over the phone, and studies have shown telehealth to be as effective as in person therapy. It is okay to ask for help, and help is still available to you.

Relationships can be challenging even in the best of times, and as we face this totally unprecedented global stressor, expect that it will present some new challenges to your relationship. As much as it is a time filled with stress, anxiety, and fear, this is also an opportunity to develop resilience and skills to navigate situations full of uncertainty. Rest in the knowledge that this is a period of trial and adjustment for us all, and be gentle with yourself, your partner, and all of your loved ones.

If you find yourself struggling, feeling stuck, and/or could use some help navigating your feelings, you could benefit from Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness, and Telemental Health Services. Dr. Shoshana Shea can help. She can be contacted at 619-269-2377.