Covid Comes to Therapy

Navigating Collective Trauma

Patrick Dougherty

For a few years now, I’ve worked with groups around the world to address collective trauma. Our focus is usually on something that had happened elsewhere and in the past: never had I imagined that, with the advent of Covid, I’d find myself so deeply entrenched in an immediate and ongoing collective trauma. One group of men, with whom I’d been working for many years, was particularly affected.

Given how close they’d become since we first began meeting, the move online naturally came as a disruption. While it was manageable at first, the energy in the group became increasingly muted as the months of isolation dragged on. Their interactions were growing tepid: the group felt like it was withering, enduring instead of evolving. It came as no surprise then that as soon as vaccines became widely available and some safety ground rules were agreed upon, they wanted to meet in person.

I’ll never forget our first group back together. Everyone was chatting excitedly, masks on, as I closed the door and told them they could finally reveal their faces. It was as if the act itself transformed these men back into teenage boys, shyly looking at each other with longing and vulnerability. There was inevitably some awkward laughter.

I asked everyone to watch what was happening in their bodies as they looked around the group. Most reported a deep inner dissonance as they negotiated the competing fear and relief of being in the physical presence of others, followed by a slow softening and eventually relaxation. A couple of men teared up as they talked about how good—and strange—it felt being together again.

WE NEED TO TALK ABOUT THIS

Soon after we began meeting in person, it occurred to me that we hadn’t talked in depth about the risk we were all taking in coming into this room together. Prior to this, there’d been nothing more than a quick acknowledgement the of elephant in the room, so at our third meeting I asked them all to confront it head-on and speak about it directly.

It was meaningful and sobering to hear everyone speak about their willingness to be there and their trust that, in the worst case scenario that they got Covid, it would be a mild case thanks to the vaccines. What would happen, however, if someone in the group contracted the virus and was asymptomatic—and what would it feel like if, as a result, it spread to others in the group?

While everyone eventually came to accept that this was an inherent risk in attending group, I remained unsettled. I’d avoided asking the group if there was anyone they were particularly concerned about infecting. Although this question went unspoken, I could feel it floating around in the room—and I could intuit that two or three of the men were most concerned about infecting me, their 70-year-old therapist who was, at times, a father-like presence. This was more than therapeutic transference: this was a potential threat to my life as a high-risk individual. This is what it looks like when the personal, collective, and professional intersect. It’s messy, and you do what you can at that time.

WAS IT INEVITABLE?

Thirty-six hours after our fifth in-person meeting, I connected online with one of the group members for an individual session. It was clear immediately that he was anxious and rattled. He stammered: “I am freaked out.”

Speaking quickly and a bit incoherently, he told me that little over 12 hours after the group had ended, he’d gotten a Covid test for a medical procedure he was scheduled to have. They’d called him a few minutes ago, told him the news: he’d tested positive. This meant he most likely had Covid in group the night before.

Hearing this, I began to get a little freaked out, too! I could feel a rush of adrenalin as my system shifted into hyperarousal and my mind began to race with all the possible personal and professional implications. At the same time, I set about trying to help him process what was going on.

The first half of that session was intense. He was mad and doubted the validity of the test, having been very conservative with meeting people in person. Then came all the questions about what he had to do about going in to work, about his daughters attending school, and, of course, about the group. We devised a plan for how to proceed, especially how to immediately contact the group members. As soon as the call ended, I began to put together a plan of my own: first step, cancelling all in-person sessions that day.

FROM REACTING TO RESPONDING

Our next group meeting was held online for obvious reasons. By then everyone had been tested and thankfully there were no other positive results. There was a moment of great relief before we set about determining how we wanted to move forward.

Everyone was anxious to begin meeting in person again except for one man: Jeremy. He explained that this exposure had helped him better understand the potential consequences of getting Covid and exposing his wife, and that he’d prefer we stick with online meetings. I could feel this land like a punch in the gut to the other group members.

The tension was high, and group members began to challenge him in ways that bordered on coercive, intuiting that his reticence to meet was not his own but rather his often-demanding wife’s. Forgetting that she often treated him as such because of his passivity and avoidance, they began to enact that same dynamic. I was getting ready to intervene when one of the group members, desperate to meet in person, offered a compromise: meeting with masks on. Jeremy agreed and there was a collective relief in the group.

FINDING OUR WAY THROUGH

Sitting together with masks on had a dramatic effect. We could see each other but couldn’t feel each other. It felt like I was looking over a fence at them, with just my eyes and top of my head showing above my mask. And it was painful to listen to each man check in as he tried to acclimate to this new way of being with each other.

Outside of therapy, all of us had talked and socialized with masks on for many months, but this felt different. Not seeing each other’s faces anymore felt like a dramatic loss, and the pain in the group was palpable. In fact, I feared for the future of the group: two of the men had made clear that they wouldn’t participate if we moved back online. I had no idea what to do.

Then something shifted in Jeremy, an academic researcher. He said he’d read an interview with an epidemiologist that morning who was asked a very specific question by the interviewer, “If five friends and I were sitting around a table and all had been vaccinated, would it be safe to take off their masks or should they keep them on?”

She said, “Well, I personally think that taking off your masks would be best because I think the mental health benefits of seeing each other’s faces would outweigh the risks involved in possible exposure.”

Jeremey explained that, having sat in the group for an hour, he could feel very acutely the truth in her statement. He said he was going to go home and talk to his wife and tell her what the epidemiologist said, and that he was pretty sure she’d be okay with us going forward unmasked, too. (This occurred before the rapid tests were readily available.)

There was an incredible sense of relief in the group, a fair amount of laughter, and lot of awe that he had read the article just that morning. Uncharacteristically for this group, nobody questioned Jeremy’s quick shift, which, to me, seemed as impulsive as his wanting to meet online again. None of us were going to risk his changing his mind.

In the last half hour, there was a giddiness in the group, a feeling that we just came through something and were now going forward in the best way possible. The masks were no longer an impediment to our connecting, but felt more like a symbolic piece of clothing that had been worn on the battle field but would thankfully soon be discarded.

WHERE WE ARE NOW

We have met in-person now for almost five months, except for one group, two weeks ago. One of the members emailed me 30 minutes before we were due to meet and said he wasn’t sure what to do: his babysitter’s roommates boyfriend had just tested positive for Covid, the roommate was currently waiting for her test results, and the babysitter was heading down to get tested. He wondered if, despite the degrees of separation, he should warn the group ahead of time or not come at all.

Again, my mind became dizzy with the complexity of possibilities, but given that that night a few men were not going to make the group anyway, I made a quick decision and moved it online.

As the wild brush fire of omicron spreads across Minnesota, we’ve begun taking things week by week and may once again move back online entirely. What the future holds—and what it means for the future of the group—is uncertain. What remains the same, however, is the unfortunate but necessary balancing act that over the past two years has become routine: weighing the longing for connection and the potential for danger. Often, we are forced to react on a moment’s notice when the circumstances tip the scales.

As I’ve said many times to my clients and myself, during this pandemic we want not to just endure: we want to evolve. When the personal, professional, and collective collide, however, is this possible? All I know for sure is that we’re doing the best we can.

***

Patrick Dougherty, MA, LP, has over 40 years of clinical experience. He is working with an international nonprofit that works with intergenerational and collective trauma around the world (pocketproject.org). He has just completed his 3rd book, a teaching memoir, My Trauma Was Never Just My Trauma: We Were Wrong. movingthroughit.com

Photo © iStock/SolStock

Topic: Anxiety/Depression | Cultural, Social & Racial Issues | Field of Psychotherapy | Men

Tags: group therapy | health

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