Uncharted Territory: Clinical Practice in the Time of a National Pandemic and Cultural Revolution

ABSTRACT

This article describes a narrative of how I became ill with COVID-19 just as clinicians began moving their practices to their homes and online platforms. My becoming ill with COVID-19 impacted the clinical work and further altered the therapeutic frame. From the perspective of a white therapist, detailed clinical vignettes depict the experiences of two white patients whose early trauma histories were reactivated by the pandemic, and highlight how their responses were intensified by my illness. I show that the change in the treatment frame, and the therapist’s vulnerability, opened new channels for meaningful work during a time of national crisis. The article ends with a comment on clinical implications of white privilege and white-centrism, and raises a call for anti-racism work in psychodynamic therapy and psychoanalysis.

KEYWORDS:

• Regression
• trauma
• racism
• pandemic
• COVID-19
• existential
• therapeutic frame

Acknowledgments

I would like to express my gratitude to Janna Sandmeyer, a friend and a colleague, who, along with Sandra Hershberg, gave me the opportunity to present and write this paper. My appreciation to both for their support and generosity. Thank you also to Adrienne Harris, ICP+P, and to my dear friend, Vincint Thomas.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Notes on contributors

Alison McGrath Howard

Alison McGrath Howard, Psy.D., is a clinical psychologist in private practice in Washington, DC. She is on the Board for the Mid-Atlantic Group Psychotherapy Society, where she has instituted the Anti-Racism Task Force to undo systemic racism at an organizational level. She sees adolescents, adults and couples, and runs psychotherapy groups.