March 2020 was a time when many people’s lives, in many parts of the world, were turned upside down.
Lockdown.
We were suddenly isolated in our homes and deprived of one of the most important things in human life.
Contact and presence.
In many ways, I had to learn how to be a therapist again.
What I had learnt about working in the therapy room, feeling the client’s presence and attuning to what emerged between us was not accessible in the way I had known until then.
Was it daunting?
Yes.
Was it impossible?
No.
Did it open a world of possibilities?
Absolutely.
I still remember my first online session.
The loss of my ritual arranging the room.
Taking it in.
Making it ready to welcome my client.
Instead, all I had to do was sit in my office and log onto my laptop and wait for my client to arrive at the virtual waiting room.
The first thing I noticed was the differences in our immediate environment. The odd feeling of being with someone who is in a different place. The limited information that meant I had to read between the lines of what was unspoken.
Was the screen a barrier or a bridge?
Could I still feel my client with me?
Is therapy the same online as being in the room?
What I noticed, not just that day, but throughout the months I worked exclusively online, was that I felt even more present with my clients. The absence of a shared space meant I had to lean into my senses more fully.
For many, the screen became a bridge. A lifeline. For some, it still does.
So, is it the same?
No, not exactly. But the differences don’t make the therapy less meaningful.
Part of my therapeutic work is for a charity where I support men and work exclusively online. My greatest joy is to see the evolution of the work and the relationship between my clients and me as the weeks go by.
Greater awareness.
Empowering insights.
A-ha moments.
Many firsts.
Secrets shared.
Online therapy can offer a different kind of access, pacing, and safety, especially at the beginning.
For some clients, beginning therapy online can feel like pacing contact in a way that allows them to engage more fully until enough safety and trust has been built.
Online therapy can be convenient for reasons like time, life commitments, lack of mobility or means.
The virtual space can be a great first step into therapy for clients who may have a challenging relationship with being seen or feeling unsafe in relationships, especially when they are feeling at their most vulnerable.
This is where online therapy can act as a regulator.
Where clients experience therapy on “their terms”
In relation to the space.
To time.
To contact.
And at the start, these elements may support the client to relax enough into the therapeutic process to delve deeper into the reasons that brought them to therapy.
Being in a familiar environment, where they feel safe, can offer enough safety for difficult feelings like shame, guilt and vulnerability to become more manageable.
It can provide enough breathing room to enable them to be more present with me.
And that can be a great resource to support the different stages of the therapeutic journey. A creative way of literally meeting clients where they are.
There have been clients I have never met in person and with whom the level of depth of the work has been as meaningful, sometimes even more so, than with those clients I meet in person.
After all, when I am with a client in whichever medium, I am with them fully.
Sometimes, working online allows for subtle, intimate gestures like:
Sharing a hot beverage.
Meeting our pets.
Seeing the progress of that home project that is so grounding.
Sometimes I can feel like I have been invited to my clients’ homes in a way that feels safe and non-intrusive. Other times I think of the possibilities that working online can bring for people who otherwise would not have access to therapy.
And the combination of the moments and the possibilities gives me hope.
Hope that many more clients have access to therapy.
Hope that they will also have the opportunity to heal.
Hope that they leave better than when they arrived.
After years of working online, my hope prevails as I sit with my clients working through and making sense of their experience, while I get to witness it and share their journey.
How did that happen? Some of you may wonder…
We both showed up.
We built a relationship based on trust and honesty.
We were present for each other.
We waded through the challenging times together.
We made it through to the other side.
In my experience, one of the main factors in making this journey possible is creating as much safety as we would have done, had we been in the same room.
How?
By asking questions.
Negotiating.
Being flexible whilst keeping safety a priority.
Experimenting.
And a lot of trial and error on the way.
As I reach the end of this reflection, I think of all the clients I have worked with and I smile.
Some I met online and some in person.
Is online therapy for everyone?
For me, the answer is no, it isn’t.
For some clients the screen becomes a bridge, while for others it stays a barrier that cannot be overcome.
And each one is doing therapy the way that feels right for them.
And to each one I thank for allowing me to be a part of their journey where we shared time and presence along the way.
Marta Carbajo Gutiérrez is a UKCP-accredited Gestalt psychotherapist working with individuals and groups in London and online. You can find out more about her way of thinking on her substack at Kintsugi Mind.