With increasing awareness of the need for mental health services following peak moments of the pandemic, and the act of discussing trauma gradually losing its stigma, many people are currently underway with the construction of their own psychotherapeutic journeys.
Mental Health Therapy In the Midst of a Pandemic...
Starting the therapeutic process post initial devastation of COVID can be a bit more challenging given the interplay and overlap between what may have already been a stressor, and the inevitable way something COVID related has affected that stressor. It seems as if people are being bombarded with issues on which they are not quite ready to work, but some aspect of their being is no longer allowing for complete silence. People are feeling intense desires to express their internal discomfort, perhaps in moments before their conscious mind has developed the language for such expressions. For those who have been in ongoing therapy for some time, even many years prior to COVID, you may feel as if momentum has been lost. Issues that you had previously considered “handled” may be finding their way to the surface again, or some of the coping skills you’ve developed have suddenly become trivial against the magnitude and brand of stress you’re experiencing.
Overall, wherever you’re at chronologically in your therapy, one thing upon which we can all agree is that we felt threatened. This threat is invisible, sometimes asymptomatic in early infectious stages, and has the potential to kill us or our loved ones. It also triggers innate responses that evolved to last nowhere remotely close to this long of a period. The imminent threat detection system in our bodies works best in seconds or minutes, taking sharp spikes and returning to baseline alertness appropriately. And because of the sustained attention of this system required throughout the last 2 years, the mental health piece to the pandemic is not by any means “over”, and many are still trying to navigate their way out of primal responses and get back to comfortable states of consciousness. It is not uncommon for all those who receive help therapeutically to feel stuck, thought blocked, thought looped, more irritable, and impatient. Therapeutic growth never happens in an upward only trajectory, however, building upon some aspect of the therapeutic relationship is an ever–present collaborative goal of the therapist and client.
What is Therapeutic Rapport?
There are in fact some ways to approach therapy that will allow you to continue building yourself and battle back against the blinding hyper-vigilance of the pandemic. Therapeutic Rapport, often referred to as the therapeutic relationship or alliance, is the strength of the appropriately bounded connection between you and the therapist. This is the “X” Factor of your therapy, the intangible subjective space that is constructed over time, fueled by trust and a consistent style of responding to all that you bring to the table. Strong therapeutic rapport can signal a more integrated sense of self and the various “parts” to your mind seem to just get along better.
3 Quick Ways to Strengthen your Therapeutic Rapport
Bring Your Creativity to your Counseling Sessions
One way to strengthen your therapeutic rapport is to express yourself creatively and bring that creativity to sessions. Discuss music, television shows, movies, theater productions, visual art, poetry, and any other platform upon which one expresses the more complex formations of the mind. Many people report experiencing euphoric highs and voided lows throughout life, and eventually mention everything felt in between. Creative arts can serve as a bridge between those highs and lows where traditional spoken word doesn’t seem to be cathartic. An overactive right brain has been strongly correlated with creative intelligence, which may explain your heightened sense of the abstract or ability to use symbolism in your life depending on the traumas you’ve experienced. Artistic sense and the use of symbolism is a phenomenon to be harnessed in therapy, especially because your mind will always try to find ways to say what was perhaps perceived as unsayable in any other relationship in your life. So, if you like to write, bring your writings to a session and have your therapist read it. If you’ve produced music, or are learning an instrument, talk about how it feels in session. Ask the therapist to listen to your favorite songs or the songs you’ve produced. If you live vicariously through tv shows or films, discuss the characters and themes in detail in session. This not only allows the therapist to continue learning what makes you “you” but invites them to pull on threads woven through the stories your artistic sense may tell.
Be Present with Your Feelings in Session
Another aspect of building rapport in therapy is shifting from a frantic search through the past for explanations of current feelings, to a sense of having the experience in session. This can be uncomfortable because of initial awkwardness of silence, but the space is yours to construct. There is visceral power to having someone sit with you through the process of feeling things that have been bottled up, without them randomly generating solutions or trying to explain how they understand what you’re feeling (something peers will do with negative effect despite good intentions). You don’t always need answers from the therapist to have an “a-ha!” moment - they are often self-induced. If you want to cry for 45 minutes straight without saying a word, go right ahead. If you feel terrible several sessions in a row, be honest about that. More growth can come from the confrontation of what is truly felt than from being a “good” client that values the appearance of growth as a form of people pleasing.
Create Achievable and Realistic Goals for your Mental Health
Lastly, and perhaps the most counterintuitive, is to lower your expectations in terms of taking big leaps in therapy during times of acute stress. Therapy is viewed analogously with physical exercise constantly, and one area that is left out is how much more delicate the brain “muscle” is than perhaps your bicep. If you exercised most days for 6 months with the same weight resistance, and then added 5 pounds and used that for another 6 months, you wouldn’t notice a drastic change in physical stature. However, if you meditate 0 minutes most days for 6 months, and then meditate just 5 minutes most days for 6 months, your internal psychological landscape will look noticeably different. Being under this level of stress for this long has us more likely to view things in a polarized fashion. It can have us perceiving moments of clarity and happiness as “fake”, and all the sadness and fear is what is “real”. Adding small, highly attainable short term therapeutic goals to experience some degree of relief mindfully is fighting against the treacherous narrative that everything is doomed, and you’re always unhappy. Using such overgeneralized terms negatively can strip your ability to sense something as pleasurable and feel gratitude for it in the future, because we are beings primarily driven by belief systems, not facts.
Having faced and continuing to face unprecedented levels of stress, it’s not a mystery that the mental health care system will continue to adapt and change as the needs of the population do as well. No matter what other stressors are ongoing, what type of therapist you’re seeing, or whether you’re in it for symptom relief or the lifelong endeavor, you can never waste your own time if you work to build therapeutic rapport. When your therapeutic alliance becomes strong enough, it takes effect outside of the session walls. Much like someone who may experience panic attacks reports a significant reduction in anxiety by simply carrying their medications with them, “carrying” your therapeutic space changes the way you respond to unforeseen stressors before you enter the next session to dump it out.
Sean O'Connor is a Mental Health Counselor at Peaceful Living in Scarsdale, NY. He helps adults and athletes overcome anger, anxiety, stress and trauma and to feel focused and empowered again.
Some of the therapies he practices include: Dialectical Behavioral Therapy (DBT) for emotion regulation
Psychodynamic Psychotherapy
Polyvagal Theory for Nervous System Regulation
Sean is licensed in New York and Florida and is available to take new clients.