Virtual/Video/Telehealth Sessions

[whiteraven]

I’m a bit scared that this is confirming my fears related to the outside world being dangerous.

^^^ This. For me, it is a worry that video sessions will remind me how much safer I feel in my home away from people. That could be a problem. Therapy has been the one thing that has gotten me out of the house (except for work) and now that I don't work, either, it's going to be really hard to find a reason to leave.

There is a real need to guide these processes, not just for those who have tech challenges, but for those who have abuses where tech, video, phones were tied in.

Wow...I never thought about this. Thanks for mentioning it...

This time though the blocks took on a whole new way of being used because I asked if I could take home the blocks that said, I’m safe and I can get help

That's pretty awesome. Glad for you!

 

[Warrior Chicken]

Thanks for this thread!

1. Have you made the transition? Is the idea of virtual sessions too frightening to switch?
2. What makes the sessions hard?
3. What has worked for you if you have made the switch?

1. I tried my first video session last week.
2. It has taken me a long time to accept my therapist's office as a comfortable and safe place, recently it has become that for me. Going to in-person sessions, although anxiety provoking most times, was the one place where I could really try to be 'me' without masks or hiding. After my first video session - I realize that a huge part of that for me is seeing my T in 3D, being able to stare at his feet when I'm struggling, seeing his hands and knowing that he's not a threat. If I can't see his whole physical person, it's disconnected and the unknown sets off my alarms.

Other thing is....in his office. I can identify noises outside, there's a barrier between the cause of the noise and me - I have time to prepare/respond to a threat if required. Via video - I can secure my location, but I'm not familiar with his. Not saying that someone will come thru the video lol.....but the noises - someone else's phone, pets, voices in the background. I can't talk about difficult subjects cuz I don't know what is in HIS space. Confidentiality is a MASSIVE concept for me, and tremendously important.

I'm not sure how I'll manage this yet. Thinking.

 

[whiteraven]

in-person sessions, although anxiety provoking most times, was the one place where I could really try to be 'me' without masks or hiding. After my first video session - I realize that a huge part of that for me is seeing my T in 3D, being able to stare at his feet when I'm struggling, seeing his hands and knowing that he's not a threat. If I can't see his whole physical person, it's disconnected and the unknown sets off my alarms.

Yeah...this rings true for me, too.

 

[Wendell_R]

It's interesting that a phone call, where there is no image of a person, or our imagination of a person, is less threatening than video, where we get partial images. With the partial, distorted images, there's room for the fears to roam and sneak in.

The physical safe space, seeing our therapist acting safe in this space. That's a big theme for all of us.

 

[Changing4Best]

I know I can't do video, because I clam up with a camera on me, no matter what the reason it is for. I can do telephone sessions, I did one Friday and it went well. However, I like to show my paintings to my T, so a telephone visit won't work for him very well.

I wish I could do a telephone visit with my regular Dr. I don't know if they allow that or not. I will call and find out.

 

[Ireusa]

I give you permission. I have both PTSD and a dissociative disorder.

I've had 2 video sessions so far. They didn't go well, but I already knew that. Well, anticipatory anxiety is a thing, and things are not normally as bad as I think them to be.

However, because I live in a tiny apartment with my 2young kids, husband and a dog, it didn't feel safe/intimate enough to be at home and possibly be overheard.

So I've been doing those in my van. The back windows are tainted black and I cover the front windows and side windows as much as I can and run the AC so it doesn't get overly hot.

I take a frozen water bottle, my fidgets, peppermint oil and my phone with me.

The idea of video sessions was terrifying but the reality was too. The 1st session I parked my van at a park thinking it would be quiet but people were running/walking by and my hypervigilance was over the top. I didn't feel safe and was not able to connect to my therapist. It didn't feel safe to discuss serious matters or feelings because that would leave me feeling exposed, but I was not in the safety of her office so what if I was to struggle a lot? What if other people would see me? What if someone was to knock on the door?

For the 2nd session I parked at a side street and covered the windows more, so it felt a bit more private. It still didn't feel good/safe and I wasn't able to connect to emotions for the most part but it was a bit better.

However, when I start to shut down/dissociate I was used to looking at her feet and hands resting on her lap as a way to ground me. Now I just see her face.

Also, her office represented a safe place/haven and it was "OK" to struggle there because she would lock the door (it terrifoed me to hear people outsode thinking they would come in, so she suggested that once and it somewhat eased my fears, as if I was hearing noises and I got scared I would see the key in the lock and that would mean nobody could come in. But now I can't control her environment or my environment.

3- Time. I am hopeful that video sessions will get easier with time, but my therapist said we might have to get creative and see what we can do, because it seems I might be going down the rabbit hole and now there is no safe place for me.

Also, she pointed her camera to the back of the room, a white wall, not facing a door. She also sent me a link to a meditation she had created that is posted online so I could listen to her. I am trying to remind myself that I'm safe constantly in the car.
I wish she had some of the decorations from her office in her house.

This is hard.

I know there are lots and lots of therapists switching to virtual sessions during the pandemic. I expect after this is over, virtual sessions will be popular, especially in under-served areas. But I also know that the idea of virtual sessions really scared me and doing the sessions has been a big challenge.

1. Have you made the transition? Is the idea of virtual sessions too frightening to switch?
2. What makes the sessions hard?
3. What has worked for you if you have made the switch?

Here are my thoughts.
1. Yes, I started with talking on the telephone, staying as Big Wendell. We talked about my fears and how to address them. Then we did just 10 minutes of video. We practiced turning off the video feed. Then we progressed to longer sessions.

2. I really need to read people to feel safe, and that means having them in front of me in person. I start to have untrue thoughts pop into my head. Seeing my therapist just over the screen, it somehow seemed that she had had sex with my teenage part, even though I know that's not true. I'm afraid I'll do something wrong and get in trouble. I feel lonely when there's not somebody really in front of me.

3. (Some of these ideas are from discussions in my Trauma Diary.) My therapist has my favorite objects on view in her office, and we begin by having her take the camera around the room to see those things. She sits fairly far away from the computer camera, so she looks the way she does in a normal session. I had to find a safe place to do the sessions, where I could be away from my family. I drive to a park and use my phone. The trees and nature in front of the car help me ground. We agree that if I say, "That's enough," it means we'll turn off the video. I make sure to bring grounding, physical items into the car, such as my journal book, water, favorite stuffed animal. I think I'll bring more little things. Interestingly, I've been paying her by mailing a check, and I wrap up the check in a piece of paper with one of my photos and a little note on it. Anything that helps connect the physical with the virtual.


I recently learned that my former therapist is growing her already huge practice and is expanding into virtual sessions. I would like to write up my experiences as a client with both PTSD and a dissociative disorder so that her therapists will have some idea of how to approach those of us for whom video is a big challenge. If you give permission, I would include your perspectives as well in my note to her (with no user names attached, but with attribution that these are not my ideas).

 

[Corkmonster]

I don't know if this post belongs here. I'm probably doing everything wrong. I don't even have the choice to do video or phone sessions. My T works for a public agency. A week ago T said they were ending my therapy--that day--bc the agency was shutting down. Blindsided. No warning. T refuses to do video therapy bc I am DID and have been doing very deep work on the torture that started at age 3. T said video or phone sessions would be harmful to us. Any therapy would be harmful unless we were in the same room. (Only 3 days before this, some very damaged screaming babies had finally trusted T enough to let themselves be seen). An attempt was made to refer us out, but all the other therapist offices are shutting down too. We came back and talked to original T on the phone. Agreement was made that I would stuff everything back inside, especially our little ones. We would put everything on hold for as long as this quarantine takes. Not try to do therapy but stay in touch by text and phone call--support only. We have been trying not to be demanding. Trying for the most part to not text very much. At first T would reply once in awhile. But now we are not hearing from them at all. We are feeling terrified and desperate. we don't know what has happened to our therapist. Maybe they are sick or something. I don't dare ask them to stay in touch. i think if they find out that I have said anything on this website they will get rid of us forever. i don't know why I'm posting this. i don't think anybody can say anything to help. I have no hope. if I could I would go to sleep and never wake up again. if I'm doing this post wrong or putting it in the wrong place, i am sorry.

 

[Mach123]

I don't like it. I have major privacy issues at home, meaning I don't have any unless I get in the car. So the real question is do, you like tele therapy in the car? No.

I find we are connected in our bodies to others and we communicated through feeling each other through our senses . I've never been as intimate with another person except my wife and it's been long term this therapist so no, doesn't work for me.

She was saying we were doing"therapy" on the phone I disagree. Its nice to chat though, because I get lonely to talk on that level with someone.

 

[Wendell_R]

if I'm doing this post wrong or putting it in the wrong place, i am sorry.

You are doing nothing wrong at all. Your post is welcome here and was good to share. You are in a very tough spot, through nothing that you or your therapist did.

 

[Ellabella44]

Hugs to anyone having problems with this.

Last week there was a technical problem on my end. Laptop had a program that is a paid photo enhancement etc package. Read up on it and solution was to uninstall it and restart computer allowing windows to replace the program's drivers with regular camera drivers. (Included in case someone has same technical problem)

Today I have appointment with my T. I think my problem with it would be watching myself durring session. I'm hoping I can put something over that part of the screen so its not visable to me. Kids are in seperate rooms on different floors of the house. My husband still goes in to work. He's a carpenter so on list of essential personnel. When and if he's sent to be home I can close the door to my home office.

 

[somerandomguy]

I'm wondering what programs people are using for teletherapy.

I use Google Hangouts Meet. I'd never used it before our virtual sessions, but it seems to work really well. And unlike most other programs, the box that shows yourself is seriously TINY. I normally don't mind seeing myself in video chat, but during therapy I'm glad to see my T almost full screen.

 

[Skywatcher]

My T uses VSee. It’s encrypted and hippa compliant. The psychiatrist made me sign a release. T didn’t.