Kirsty Toal, Art Psychotherapist
Online therapy is a much discussed and documented subject at the moment, as therapists of all disciplines have been forced to reframe their practice and adjust to working away from their clients. There is extensive advice and opinion being shared about confidentiality, safe working and how to make the best of the situation so I want to simply describe some of my experience and how it has helped the work in new ways from a distance as I shield due to my own health, away from the therapeutic community in which I work as an Art Psychotherapist.
Right now, I am fortunate enough to be close to woodland and I can walk over hills and splash through muddy puddles and fields in my free time. One warm day my partner picked some nettles (stinging his hands somewhat in the process despite his gloves) and announced that he was going to make nettle tea. It brought to mind the Hans Christian Anderson story of ‘The Wild Swans’ (which was introduced to me recently, in Psychologist Sharon Blackie’s book, “The Enchanted Life”). In the tale a young princess rescues her eleven brothers who have been cursed, turned into swans and banished from their home. She saves them from suffering on the advice of a fairy queen, spinning the stalks of the nettles into yarn and weaving them into eleven coats, one for each brother to wear. This breaks the spell, frees them from the curse and returns them to their human form, and to their home. The harsh stinging nettles were worked into healing and restorative garments and the nettles in my kitchen, after drying in the sun and soaking in warm water, have been calmed into soothing, warm tea.
Since that walk I’ve had nettles on my mind, especially the way they push us away and stop us from accessing their helpful qualities. They really force us to value their worth if we have courage to endure their stings and to see what lies behind them. It has been a meaningful metaphor in my adjustment to working remotely in a therapeutic community. Working with technology has come with prickly incidents of sound disappearing, cameras malfunctioning, wifi dropping out and, that one big sting, not being physically present. It has, however, been worth persevering and I am regularly heartened by, and learn from, the resilience and adaptability of our residents and their willingness to do their best despite the challenges.
As an Art Psychotherapist I was particularly concerned about how I would see subtle gestures through a screen, like the way pastels are pressed into paper, paint splashed onto canvas or fingers pushed into clay. I might not hear gentle sighs or notice the shuffling feet under the table, and I might not be able to effectively show my own responses.
When working with the broad experiences of those living with psychosis and other issues, I have learned that it is often the subtleties that matter, where words are not enough. After some initial difficulty, we have begun to renegotiate what therapy could be, what it could look like and how it would work. Now, each of my clients are figuring out a different way to either carry on our work or to put it on hold until we meet in person again or review again later.
Some people may welcome the distance of online working and feel free to express themselves while others might not want to be seen or worry about security so turn off their cameras or choose not to attend therapy at all. Some may feel abandoned and others may feel that even at a distance they are remembered and valued. There can be a sense of closeness and connection through the small window of a laptop or phone screen but there can also be a frightening sense of aloneness that comes from sitting in a room looking at an image of someone who seems not as real as they were in person.
Right now there is a resetting of personal limits amidst unsettling changes that may mirror what is happening out in a world where there is an, all too often heard, narrative that says “everything is uncertain, risky and unsafe”. I’m reminding myself daily that all of the above responses are ok because we are all finding our way in new territory.
A safe space
A few years ago, while training as an Art Psychotherapist, I researched the potential of digital environments being used in therapy. It seemed exciting and almost limitless with so many possible new ways of people relating and recovering through carefully designed virtual environments and avatars. I then went on to do some inspiring introductory training in Environmental Arts Therapy. Since then I’ve worked on skype a little and have taken people to work outside in nature among nettles and bluebells alike. These two very different experiences have been valuable in working out what it takes to create the possibility of safety in an environment that we do not always have control over. For some people safety feels an impossible state but as a therapist I hope to at least introduce the idea of it for people by considering questions together such as:
What is uncomfortable about this and how can we make it more comfortable?
What past experiences are being recalled as we face this change?
How can this new approach help us?
Being on camera can be exposing, uncomfortable and restrictive but I’ve also discovered (quite unexpectedly) that it can become connecting, comfortable and incredibly therapeutic for people.
In therapy, welcoming someone into the same room each week may offer some certainty in what can be an unstable time in someone’s life. The space itself can become meaningful. The chair, the clock on the wall, the plant on the windowsill and the art work made and kept safe can become symbolic of all that is revealed, examined and left behind over the course of therapy. This, I am finding, is also possible (with some figuring out with my clients) in the virtual space that connects us during therapy.
Now amidst social-distancing restrictions therapists and clients alike will be redefining how we all work. The ways we find to do this will be varied and will depend on the modality of the therapist and the preference of the client among other things like what is actually available to us. Together we will need to consider the meaning in distance, the virtual space and what is revealed within the metaphorical stinging nettles that can actually be healing and supportive. I am planning to work safely indoors again soon, as well as outdoors and online, but with a refreshed view of what therapy can be and how creativity and flexibility can enrich the work.