Be Kind to Yourself…For Us!

Welcome to a conversation between two social therapists, Hugh Polk, MD and Ann Green, Psych NP who meet regularly to share and advance our therapeutic work. This dialogue shares a recent conversation about our therapeutic work in the midst of the Covid-19 pandemic.  

Ann: I’m in love with my group! We’re having a love fest. People have really grown in their capacity to be loving and giving.

Hugh: Wow. That does sound wonderful…and maybe a little weird, too – but in a good way. Tell me about it.

Ann:  Well, one of my groups has been working with a group member, Alma, an emergency room nurse. She’s dedicated, takes her job very seriously, and gets a lot of gratification from it. It’s a demanding job in normal times, but with the coronavirus outbreak, the demands on nurses are beyond enormous.  

About five weeks ago, when NYC was just beginning to practice social distancing, the group checked in with Alma to find out how she was doing.  She told us that her ER was unbelievably busy, the whole staff was working flat out, 24-7 – and she was determined to likewise “work ‘til I drop.” The group was taken aback, and several people became quite upset. “We don’t want you to work ’til you drop,” they said. “If something happens to you, it’ll have a terrible impact on us, not to mention your patients and co-workers.”

Hugh: Can you give me some of the history? How did the group build a relationship in which they could make this kind of demand?  

Ann: Well, Alma’s been in the group for over a year. During that time, the group has asked her to take a look at  how she sees her “self-worth” solely in terms of her job.  Alma tends to be very self-critical, and over time, the group has pushed her to let herself experience their respect for her.  In the course of that work, the group has grown to care a lot about Alma – and she about them.

They had built a level of intimacy in which they could challenge Alma on her commitment to “working herself to the bone.” She told us that, like a lot of healthcare workers, she feels guilty because she can’t save every patient stricken with the virus.  The group objected to her self-blame and guilt. They wanted her to try and hear that they loved her for her devotion to her patients, and that they also wanted her to take care of herself.

Hugh: They were asking her to do something new: “Hey, we’re asking you to take care of yourself. Do it for us!” How did she respond?

Ann: The next week she thanked the group for making her feel cared about in a way she’d never experienced, and that she had followed the group’s direction to keep guilt out of the picture with her patients . Unfortunately, she had tested positive for the virus, was quarantined, and was  taking care of herself as best she could – as the group had asked.  

Hugh: How did the group respond?

Ann: They said they were touched and proud that together they had helped her transform how she was doing her job and her life.

Hugh: How did you feel about the conversation?

Ann: I felt proud of them.  They’ve come a long way over the past four years to build relationships that are both caring and demanding. Now, they’re able to challenge each other to grow, to do things in new ways, to change their lives.  It’s extremely meaningful to me. I love it, and I love them.

Hugh: Did you tell them that?

Ann: I did!  And they got very emotional and said they loved me too. It was so moving.  The work felt new and intimate. They’re decent, ordinary people who are struggling to be more open and help each other. I find this very beautiful.

Hugh:  Yes. You’re creating new conversations, new emotions, new forms of life. No wonder you love each other.

Ann: It means a lot to me that you say that, Hugh. I was worried that maybe I had gone too far. In “therapy school,” we’re taught that when clients feel emotionally close to their therapist, it is to be understood as a form of “transference,” and when therapists feel close to their clients, it means that there’s “counter-transference.” Both are problematic, inappropriate, and for the therapist, potentially unethical. But the more I thought about it, the more convinced I was that the closeness we had produced in the group was not pathological.   

Hugh: It doesn’t sound like pathology to me – far from it.  You and the group have an important relationship that you’re creating together week after week. This includes breaking down the authoritarian barriers that keep people in their places.

Ann: The pandemic puts life crisis front and center – and the group grapples with how they want to deal with crisis. The “how” of the approach makes a huge difference.

Hugh: Yes, there’s a strong tendency in a crisis to just wait it out, or do the same things you’ve always done, or to ignore what’s happening. But your group didn’t do any of those things—they waded in and got involved in Alma’s life. The Covid-19 health crisis is tragic and terrifying, and yet it also presents opportunities for development. 

Thanks so much for sharing this with me, Ann. It’s inspiring.

Ann: You’re welcome.