During the ongoing lockdown many therapists are replacing face-to-face appointments with remote sessions that can feel unworkable for some. A therapy patient shares her guide to adapting.
Recently, a traumatic experience from my past came up.
I had just finished my six-month course of skills-based Dialectical Behavioural Therapy. DBT is based on four main concepts: interpersonal effectiveness, distress tolerance, emotional regulation, and mindfulness. It was helpful, especially the distress tolerance, which helped me come up with ideas for how to look after myself in difficult times, which is so relevant right now. We talked about self-care, distraction, crisis plans and more. I also found that being creative with mindfulness helped me discover that I can do it after all (I’d always previously been put off by the idea of mindfulness).
However, I felt a little disappointed that ultimately, I was still in a bad place. This wasn’t helped by the memories, and I decided I would try to seek out further therapy, preferably with a trauma-based approach.
Then came the UK outbreak of COVID-19. Lockdown began, and even my care-co-ordinator was less able to offer appointments, let alone the charity that I was hoping to go to for therapy.
My diagnoses include EUPD (emotionally unstable personality disorder, also known as borderline personality disorder), and autism, which both make any change really hard for me. The current situation in both this country and the wider world, of course, aren’t just a small change. I find it hard when plans get changed, let alone when my day-to-day life is suddenly totally different.
Alongside the disruption, there is now a big part of me that is terrified. Without much support my structure is gone, and initially I felt pretty much alone to process my trauma.
I now consider that actually, there are still steps I can take to help me cope as best I can.
Many are finding it really important to continue connecting with others during the lockdown. This might be those you live with, or people outside of your household. There are plenty of ways to keep in touch, like a call, video call, or even a letter.
What about professional support?
Perhaps most importantly, connection during lockdown means keeping in close contact with your care team if you have one. These are the people you work with for your wellbeing. Here I mean mental wellbeing, but if you have other conditions this may also be for physical health. My care team, for example, includes a care-coordinator, a mental health employment coach, and a psychiatrist. It used to also have my two group therapists involved.
A good team will try to adapt and help you develop a care plan, especially if you’re like me, waiting for therapy. You could suggest lots of means of contact, like those already mentioned, or emails and texts if calls aren’t easy for you.
This may become difficult at times, especially with a potential lack of quiet space in the house to talk, but you should try to discuss with your team how this may work whilst you’re stuck at home. That might look like a conversation with your family or housemate/s, or sticking to text-based contact like emails.
If you are waiting for or feel you need therapy, and can’t access it suitably during the COVID-19 pandemic, there are plenty of resources available online. This may take some research but if you have a diagnosis, you can look into recommended therapies and then find books or e-documents from there.
- Mental Health Today's parent company Pavilion publishes a range of mental health books, along with an online subscription service featuring curated and exclusive mental health resources: Mental Health Knowledge.
Often, you may find that one type of therapy is particularly well-researched and is helpful for your diagnosis more than others. I have given one example of this: dialectical behavioural therapy for emotionally unstable personality disorder / borderline personality disorder. Another example is cognitive behavioural therapy for obsessive compulsive disorder and CBT.
- See also: What worked for me? Cognitive Analytical Therapy
- See also: What worked for me? Dialectical Behavioural Therapy
- See also: How long should I expect to be in therapy for?
If you don’t already, read up on types of therapy. Look for what it covers, and the symptoms it is good for. You may find a good match and be ready to look for a referral when we come out of isolation.
It will take a lot of energy at times to continue to look after yourself. For me, being stuck without therapy has meant I am putting a lot more effort into keeping myself going both daily and in the longer term. But I know it is possible. Sometimes I reflect back on other times where I’ve needed to be independent in looking after myself. These memories can be difficult however, so it’s important to make sure you feel emotionally able / ready to do so.
- See also: I need urgent help
- See also: I have experienced or witnessed something traumatic
Even though it takes more energy without therapy or routine and when stuck in the house, it is absolutely worth it. You could try to come up with creative ways to manage, perhaps by making mind maps [a diagram for how you will approach things] or something similar. I’ve actually found that by getting creative with how I think, I’m finally breaking bad habits that I’ve been working on for years in therapy.
Whilst it’s hard going without when I’ve been under mental health services for six years, including lots of therapy, I know I can do it. I am finding new ways, every day.
I continue to draw stength from personal interests too, including yoga, creative writing and art. You will have your own.
While we wrestle to adapt, it’s always worth remembering that this will be over someday soon, and life will pick up where it left off.
The World Health Organisation advises people experiencing anxiety related to Coronavirus to put a daily limit on their consumption of news related to the pandemic.