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Virtual Sessions Made Me a Better Therapist

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At the beginning of the Covid-19 pandemic, I was lucky enough to decamp from the nightly sirens in Brooklyn to a house in rural upstate New York. Cut off from my office, I offered Zoom sessions to my patients, but I privately told my friends, “If this pandemic lasts more than two months, my patients are going to leave me. ” It did, but they didn’t.

In fact, they seemed to need me more than ever, even if only through a screen. Virtual therapy wasn’t just a lifeline for my patients, it helped me feel some sense of normalcy too. But the biggest surprise was that I was becoming a better couple’s therapist, not despite the new technology but because of it.

All too often in my practice, couples sit in my office screaming at each other. The first time this happened on Zoom, I began to make the familiar “T” sign for “time out,” when I suddenly realized I had a mute button. With a feeling of stepping off a ledge, I reached down and muted the shrieking husband, while hastily typing a comment in the chat to tell him why.

Almost instantly, he stopped yelling and with a sheepish grin apologized. From that moment on, I warned my couples in advance that I would mute anyone who shouted over their spouse. It’s been a game changer.

Yelling activates the fight-or-flight response not only in the yeller, but in the listener. Blocking that interference has allowed me to help my clients communicate more effectively. Often, the warning is all I need—I never even touch the computer.

As time went on, I discovered the mute button could do more than just inhibit shouting, it can enhance listening. Listening is not just hearing; it is taking the time to understand. Couples in therapy frequently talk over each other, impeding the important flow of feelings and ideas.

Often, one person leapfrogs ahead to what they assume their partner is about to say without actually listening to them. “What did she just say?” I’ll sometimes ask, knowing that I’ll rarely get the correct answer. Now, rather than quizzing the couple, I just hit the mute button.

“Right now, we are both going to listen to each other,” I’ll say when they abruptly stop talking. “And I’m going to mute each of you in turn, so you can really listen to each other. ” After one such episode, a husband who’d often complained of his wife’s emotional coldness, said, “I didn’t know how much fear there was for you.

” His normally stoic wife burst into a sob. He looked at me, perplexed, from the computer screen: “That was all it took to get through to her?” Deep into the pandemic, as my clients and I remained virtual, I found we were doing better work. The couple on the brink of divorce decided to confide their secrets instead.

The couple that hadn’t had sex in six years began sharing their fantasies. Couples in separate places were finding a level of emotional safety they hadn’t felt sitting next to one another. Without the physical proximity, my patients seemed to take more risks.

And a willingness to risk is what makes therapy, particularly couples therapy, work. It is not difficult to extend the lessons I’ve learned in my virtual sessions to every couple in their own homes. My advice is to begin by not talking—literally learn to “mute” yourself.

Pausing to actively listen is not our instinct; we rush to tell our side of the story. But when you create space for silence, you listen more. That reduces assumptions about your partner and encourages greater empathy and deeper intimacy.

Heather Genovese, a psychoanalyst in private practice, describes listening as “critical to making space for another’s feelings. It makes your partner feel that they matter. ” She cautions, though, that “active listening is never about finding solutions.

Being distracted by behaviors like checking a text, losing eye contact, and interrupting shuts down communication and ultimately leads to disconnection. ” The second lesson I derived from Zoom is that removing yourself temporarily from an escalating conflict is critical. When things get tough, the best solution is often not to jump into the ring to duke it out, but to retreat to your respective corners.

Because my Zoom couples are often beaming in from different locations, it becomes a relatively simple matter for one of them to end a session. In real life, fight often takes precedence over flight, but it shouldn’t. Taking time out from a fight, going for a walk, or getting a drink from the kitchen can de-escalate and defuse conflict.

In other words, come back to the conflict later when heads have cooled. This is harder than it seems. Who doesn’t want to solve a problem in the moment it occurs? But living to fight another day is critical to resolving any kind of conflict.

The third lesson we can derive from Zoom is not intuitive. It’s to “take space. ” But that doesn’t mean just leaving or pausing the conflict when it escalates.

It means literally changing the physical space between the two of you. When one or both of you stop feeling understood, transform the conversation by changing physical positions. That might mean going to different rooms and continuing to speak virtually rather than in person, changing to text from voice or vice versa, going to different parts of the house to speak by phone, or sending each other voice memos.

When something isn’t working, don’t dig in. What this can do is reset your nervous system by allowing you to catch your breath. Releasing even a little bit of tension can return the autonomic nervous system from an overactivated sympathetic state to a more balanced parasympathetic state.

Jocelyn Charnas, who sees couples in Manhattan and specializes in premarital therapy, was not surprised that simply changing positions could elicit such dramatic results. “All couples have bad relational cycles, and there’s rarely any breathing room between the components of those cycles. Any way we can provide space between the components can breed insight, compassion, and empathy.

It’s the digging in that we are trying to move away from. ” “It’s when I need you most that I withdraw,” one wife texted her husband, abruptly shifting the conversation after they had moved from their battle positions on the couch to texting in different rooms. Just as the couples Zooming in from different spaces were suddenly less deadlocked, moving from voice to text allowed them to exit the destructive cycle of hurt and withdrawal in which they’d become ensnared.

“What?!?” he texted back. “You always just tell me all the mistakes I’ve made, how badly I disappointed you. ” “I know,” she said, “but it’s because I feel so vulnerable, I have to push you away.

” Technology has helped my patients slow down, pay better attention to each other, and feel less powerless when they are scared. The instinct to protect yourself, especially when you feel wronged, is human. It will always be easier to stay in the Chinese finger-trap of being “right.

” What I’ve seen, though, is that my patients who battle these urges connect more profoundly. “The ability to be vulnerable and open and risk sharing your true self,” Genovese stresses, “requires tremendous internal strength. ” It is also the surest way to lasting connection.

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From: wired
URL: https://www.wired.com/story/virtual-sessions-made-me-a-better-therapist-you-better-patient/

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