How Teletherapy Changed My Life and My Practice
Like many of my colleagues, I was called to social work by a deep sense of wanting to be of service. It wouldn’t be a lucrative career, but I refused to let the healing gifts I knew I could offer depend on the amount of money I could rake in.
My family’s personal history in the foster care system led me to begin my career in the same organization that once threatened to tear my mother away from her siblings. There, I helped teenage girls to nurture unplanned pregnancies, guided teenage boys to embrace the unique beauty of Black manhood, and demanded funding so clients could have access to a college education. I went to crumbling apartment buildings to reunite families, and I met with corporate executives to finance our special projects. I felt connected with my true nature as a helper and healer, and my work filled me with a sense of meaning and purpose, even as the realities of postgraduate life set in: debts to pay off, a mortgage to cover, and eventually, two children of my own to care for.
With my supervisor, my focus at that time was to spark a desire for education and entrepreneurship in the adolescents who’d soon age out of our system. But as we continued to develop successful programs that might transform our clients’ lives, we faced increasing resistance from the people who paid our salaries. I was blocked from offering services to young men if they’d committed a petty crime, and I was forbidden from visiting them if they were arrested. Rather than aging out to college or a job, they’d often return from jail too old (and far too wounded) to return to foster care. I became increasingly disillusioned by what I came to see as an oppressive system, which professed to be in service to children but was really a launching pad to a prison cell.
Finally, when my heart had been broken a thousand times by the systems in which I’d tried to be of service, I summoned the courage to open up a private practice. I dreamt of serving my community in a space that I could control, and of untethering myself from the insurance companies that demanded I quantify my client’s experiences with some DSM diagnosis that could follow them around for the rest of their lives. I named my practice The Heart Nest. And although I didn’t accept insurance, I allowed clients with less economic resources to pay what they could.
My tagline for The Heart Nest was “Heal. Grow. Soar.” It became a space for clients to reconnect with their innate wisdom and enhance their spiritual practices. My training in Sufi healing, trauma, and integrative health allowed me to be creative in my approach to addressing wounds of the mind, body, and spirit. Many other healers of all sorts—clinicians, acupuncturists, massage therapists, yoga instructors, and nutritionists—launched their practices there, before moving on to open their own spaces.
But as much as I cherished my private practice, there were times when the beauty of it was overshadowed by the burdens of owning a business. The rent needed to be paid, the phone needed to stay on, and the fax machine, which I never used, needed to be wired and fed. Practitioners who shared the space often took flight without advance notice, and some seemed to see paying their share of the rent as optional.
My name (and reputation) was on a commercial lease, making the more than $3,000 needed to cover the overhead the most important line item of my monthly budget. Despite my dream of making the space affordable for new practitioners, I found myself raising their rent each year. I also ended up cutting the number of reduced-fee clients I could take on and increasing my own fees, which meant the people I most wanted to serve had limited access to my practice. The theme song of my business shifted from “You Are the Sunshine of My Life” to “Ain’t Nothing Going on but the Rent.”
There were several moments in which I pondered walking away from my office space. Instead, I nourished myself through traveling—to the Middle East, Central Asia, and Africa, and all across the U.S.—doing meaningful work in global trauma relief with The Center for Mind-Body Medicine. Overall, life wasn’t bad for this little Black girl from the Bronx, but she spent many nights wondering how she could answer her true calling to serve others freely without going broke.
In mid-March of 2020, when COVID landed at America’s doorstep (or when officials decided that its presence could no longer be ignored), I was teaching in western Maryland, in a historically impoverished, largely white community struggling to come to terms with its losing battle with opioid addiction. The next morning, the whole state was almost completely shut down. I rushed back to my office to email and call clients, reassuring them that I’d do my best to walk them through the uncertain tides of our collective new experience. Although I wouldn’t be able to do it in person, I let them know I’d be there for them, albeit in a virtual space.
For a while, I conducted video sessions from my office, hoping its familiar orange and turquoise hues would bring some ease to my clients’ nervous systems as they sat in their homes, in states of high anxiety, hearts tight, asking how they’d manage the multiple roles of spouse, parent, teacher, and breadwinner. After just one week, they were already expressing feelings of fear and weariness, struggling to find a place to breathe. My familiar setting, coupled with our ritual of beginning every session with the breath, served as a simple yet effective way to bring them back to homeostasis.
Of course, I was experiencing my own fears and concerns about the future. And after a few weeks of going virtual with clients self-quarantined in their homes, I realized it was time to figure out how to work from mine. My younger daughter had been plucked from her sophomore year of college and was home with my husband, who’d abruptly become unemployed. We were blessed with health, a refrigerator full of food, electricity, and strong WiFi, but COVID’s shadow was darkening my home, and I felt I needed to be there.
Unlike the carefully tended space of The Heart Nest, my home office was covered in dust and years of accumulated clutter. A room hardly big enough to turn around in, it housed three litter boxes, a three-foot kitty bed, four large file cabinets, and an old TV tray, where I cleared a space for my computer and, thus, my clients.
That first Monday morning at home, I had three new clients on my schedule. They represented what’s now a constant in my practice: highly functioning people who’d considered therapy in the past, but hadn’t allowed themselves the time to slow down and focus on self-care until the pandemic. The work we did together became part of my growing list of what I call CoronaGifts—the many blessings that unexpectedly appeared that summer even as COVID raged through our communities and racial injustices tore into our hearts.
Chantel, an African American grandmother in her late 40s, was referred to me by a former client. The intake form she filled out online stated that she was tired of being single, a feeling that was becoming exacerbated during lockdown. I started our work by inviting her to bring crayons and paper to our session, which she attended from her spacious bedroom, and asking her to draw her biggest obstacle with love.
Although I couldn’t see the paper as she drew, I could see the concentration on her face. Finally, she held up a picture of an unrooted tree, at first holding it too close to her screen for the camera to focus, and then moving it back with a small, apologetic smile. “I don’t have any roots with love,” she sighed. “I was always taught that love came with conditions; that’s why I’m trying so hard to show my granddaughter love, no matter what she does. I don’t think I was able to do that with my kids, and maybe it’s why I can’t find a partner now.”
“What about the love you show yourself?”
Her nervous laughter masked the tears that, despite the virtual space between us, I could sense were rising to the surface. “What’s under your tears right now?” I asked.
She was surprised I could feel what she was trying so hard to tamp down. “I never cry,” she said, but with those words came a pent-up flood. I paused with her, emphasizing the rise and fall of my own breath, inviting her to breathe with me again.
“I’ve never loved myself,” she told me, looking off toward something at the other far end of her bedroom I couldn’t see. “If my friends heard me say that . . . I’m always the life of the party. And they think that just because I was married, I know love.”
I gave her my working definition of love, taken from M. Scott Peck’s book The Road Less Traveled—the commitment to the spiritual growth of another person and oneself.
“I never thought of it like that,” she said. We began to explore all the ways that love had already shown up in her life—and the ways in which she’d been unable to receive it.
“Were your children conceived in love?” I asked.
She pondered the question. “You know what? They were. Yes!”
“Then close your eyes, picture them in front of you, and see if you can tell them how grateful you are for them.” She closed her eyes, and I saw a soft smile on her lips. “Now imagine your ex, and see if you can thank him for the moments of love that led to the birth of those children.” I reminded her that even though the relationship may not have ended the way she imagined, closing her heart to its beautiful moments was actually closing her heart to the possibility of more love.
The following session, she informed me that her ex had come over to see their grandchildren, who’d moved in with her during the lockdown. While he sat in the backyard, she offered him some dinner, and for the first time in years, they shared a moment of sincere laughter. “I was so proud of myself for seeing our relationship as something important, even though we’ve been at odds for so long. I can still love him as the father of my children. I don’t have to frown when I hear his name or run from the room when I hear his voice.”
Over the next few weeks, I helped her slow down, go inward, and offer herself love, too. Together, each in separate parts of the city, we’d put a hand on our chest and allow the warmth to enfold us.
Part of the gift—and the challenge—of this time was that my clients were showing me the extent to which I too needed to slow down and tend to myself. While I made sure that they always saw the best side of me—face and heart clear, neat and tidy background on camera—I vacillated between focusing on their issues and concentrating on my own challenge of clearing years of dust and neglect from my home office.
First, I cleared out the four towering file cabinets and narrowed them down to one. Then, much to the dismay of BaybeeKat, Madame Buttons, and CJ, I moved the kitty litter and cat bed to the basement. They protested the transition by presenting me with early morning furballs below my chair and defiant prances across my laptop during critical moments of my sessions. I responded by pausing throughout the day to scratch their ears and brush their fur.
My extroverted self was beginning to thrive and blossom in a space that allowed me to hug my beloved family several times throughout the day, depositing kisses on their foreheads before heading back to my home office to work. It’d been years since I was able to enjoy a weekday cup of coffee at my table, or an afternoon bowl of hot popcorn. For the first time in what seemed like decades, my suitcases were completely unpacked and placed in the attic. The simplicity of our days reminded me of the African village where my husband was born. And in the wee hours of the morning, I snuggled under his neck, breathing in the stabilizing scent of “home.”
My workdays started early, before the rest of the house awakened, allowing me the space to clean a little more. Each morning, a new relic from my past appeared, asking me, “Sabrina, where have you been?” My recurring answer was: “Everywhere but here.”
As I worked through piles of papers, I unearthed remnants of a glorious life. Notes and drawings from my daughters reminded me that despite their adolescent angst, they were destined to fight oppression with greater vigor than their mama. Expired passports reminded me just how many parts of the world I’d been blessed to see. Christmas photos from friends from all over the world reminded me how much I was loved. Reams of papers and articles I’d written reminded me how hard I’d worked throughout my career. And a tattered copy of my master’s thesis reminded me of my essential truth: psychotherapy is an act of love.
Sitting on the floor and rereading my writing on love as the therapeutic alliance, I briefly relived a vicious verbal attack from my then-clinical supervisor, who couldn’t separate love from sexual attraction or an abuse of power. I paused to pray for that woman, who I felt had clearly lost sight of the essence of her work. And to my surprise, I realized that—in an office smaller than the average American closet, in the darkest hours of a global pandemic—I was on the verge of reconnecting with the essence of mine.
I felt the signs of a deep spiritual awakening in me. In Sufism, we often land at answers through a daily recitation of the phrase Ya Haqq. Although it may sound strange to some people, this practice, along with meditation and journaling, revealed to me that, although I was headed for one of the most challenging times in my life, it would ultimately return me to my true nature as a healer.
While I had yet to understand what that looked like, images began to emerge for me that slowly revealed my path. One day, scrolling through the thousands of photos on my phone, I recalled my visit to the Mount of Temptation, above the town of Jericho in the West Bank, where some Christians believe Jesus retreated for 40 days and was tempted by the Devil to abandon his message of love. It hit me then—the root of the word quarantine is 40 days. But I needed a different kind of quarantine than the one many parts of the country were being forced to undergo. Mine would be a 40-day retreat of self-reflection, in which I could land at the best decision for my life, personally and professionally.
Knowing that I couldn’t disappear from my clients or my family while we were all experiencing so much acute grief, my retreat was internal. I deepened my morning practices, rising earlier than ever, praying in the dark, and journaling by a small light in my living room. I increased the number of days that I fasted each week and added an extra half-hour of meditation to my afternoons and evenings.
Eventually, I invited my husband and daughter to help me explore the next steps for my practice, brainstorming ideas about what this might look like if I made the transition to virtual therapist permanent. Could I afford it? Would some clients leave? Would the landlord sue me? What about the other therapists in my office? Am I being selfish? Could I really stay in the house all day without losing money? Or my mind? I knew that COVID was asking me to change and reevaluate my resources. I just needed to sort through whether I could be an effective healer from my home.
Back to the Heart
My 40 days of self-reflection ended on the first day of Ramadan. My morning journal entry read, “My home is my Nest. The Heart Nest is at home.”
The next morning, I crafted a letter to my office landlord, making an offer to settle the outstanding rent and submit my 90-day notice to vacate. Once he accepted, I slowly began the process of relocating my nest, bringing items home in small, manageable loads I could fit in my car. First was my tree-shaped desk lamp—one of my first purchases when I established roots in that space. This was followed by a nest-shaped basket full of miniature gemstone hearts that I’d collected in my travels. When I lifted my framed picture of lotus flowers, etched with the words “Live, Love, Laugh,” a tribute to my grandmother, I whispered, “Let’s go home, Big Mama.”
My husband and daughter spent weekends at the office with me, sorting years of collected items into three neat piles: keep, donate, sell. The sold items—a hand-painted room divider, custom floor cushions, and African-inspired wall hangings—were listed online at bargain prices, and the funds were donated to charity. As my office space grew increasingly bare, each room of my home started to take on the familiar scent of my practice—alive with new bursts of colors, textures, and images.
Finally, I was ready to face the task of sorting through my client files. My husband offered to help me shred the older records I was legally allowed to release, but I knew this was something I had to do alone. In the sweet cave of my file room, I was greeted with a flood of memories, every client who’d entrusted me with their heart for the past 12 years—the pregnant teenage girl with hyperreligious parents, the sex-addicted woman with the generous heart, the white police officer who’d cried for a full 50 minutes each week, the couples who’d shared their darkest secrets, the accomplished Black women who’d just needed a place to breathe, the survivors of horrific trauma, the people struggling with addiction who’d never stopped reaching toward recovery.
Now that I’d no longer share a physical space with my clients, I needed to adjust to connecting through a screen. So I personalized my virtual waiting room and greeted clients with the same Native flute music or African drumming I used to start in-person sessions. I learned to work with what was at hand—a central teaching of this pandemic—and invited clients to keep sacred items and special scents nearby for sessions. Since I wasn’t in the room with them, these served as grounding tools for when we explored challenging issues. For instance, when we discussed her fraught relationship with her mother, my client Daphne, who struggled with disassociating when triggered, used a sage-and-lemon spray to bring her back into her body and remind her of her tremendous capacity for resilience.
Via webcam, I guided my client Samantha in designing a meditation corner in her busy home. In real time, we discussed where she was placing her cushion, a small photo of her grandmother, and a meditation bowl she’d bought online—and we explored how she’d ask her family to respect this space. With her laptop placed on the ground in front of her, we practiced some guided meditations together in her space—something that never could’ve happened in my office. And when her 12-year-old started pounding on the door, we practiced breathing through her frustration and responding in a calm way.
Other benefits to working virtually appeared as well: Rosa, my client with one car, no longer had to cancel at the last minute when her husband had to work overtime. When Maya became sick with COVID, I could see her while she rested in bed. She spent the first half of our session shedding tears of relief that she could still lean on me in this stressful time. Then we strategized ways to enhance her health and relieve her anxieties about being isolated from her family.
Throughout the days, my clients and I were often greeted with periodic “screen bombs” from pets, parents, baby bottoms, and choppy internet connections, but the laughter we shared around the chaotic aspects of our lives creeping into our sessions served to deepen the bridge between two human beings adjusting to a new reality.
The coronavirus has brought so much pain and suffering to the world, but it also brought me back home.
Over these last months, I’ve fallen more deeply in love with the house in which I raised my children—and with my work. The shift from an overhead-focused practice allowed me to return to the core of what I always wanted to do—provide therapy to everyone who needed me. My caseload is no longer quantified, and my acceptance of new clients is no longer predicated on their ability to pay. I’ve been able to expand my online groups and courses, and to say yes to requests to lead workshops with organizations across the country without the burden or expense of travel.
In fact, since I no longer need to take days off to recover from jet lag, I’ve been able to take on more clients—which ultimately, though it’s not my objective, has generated more income than before. And even though my schedule is fuller than ever, I have the pace and energy to regularly ask myself, “Who needs me now?” In the early months of the pandemic, the answer was airline staff. So I offered to run a series of free virtual workshops and mind-body skill groups for furloughed flight attendants. Recently, I made room on my calendar to see dozens of unemployed clients and mentor several aspiring African American group facilitators.
With the slower morning pace a virtual practice afforded me, I’ve been able to think deeply about my response to an ever-growing number of senseless Black deaths on our American streets. I saw how my Black brothers are experiencing the rage of their brothers’ murders, while grieving the death of countless Black matriarchs to COVID-19. So I started Project Big Mama, to collect the names and stories of the many African American women who’ve passed away during the pandemic without the ritual of a large traditional burial, funeral, or repast.
I cry frequently these days, even with my virtual clients, knowing no one is exempt from the world’s sorrow. But each morning, I feel blessed to greet my workday. Before heading downstairs to my home office and turning my computer on, I can choose to meditate to the sounds of my husband’s lawn mower and pause to enjoy the melody of a neighboring child’s laughter. Healing is happening in every corner of my virtual nest, revealing itself as yet another CoronaGift.
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