Inspiration from the Depths of Care
During COVID-19
“There is no greater time for us to walk the walk, dear team,” I say to my True Life colleagues during our daily morning meeting. Four weeks into a new reality of online treatment for patients with serious mental health conditions, we’re all noticing how much more draining it is to conduct video chat therapy sessions than to sit with our patients in person. As a team, we’ve been navigating this challenging transition by reminding ourselves of our strengths and encouraging each other to practice the very same self-care skills that we advocate for others.
Having committed partners-in-care at a time like this has been crucial to maintaining our collective mental health and stability and being available to the vulnerable people who rely on us. Still, there are quiet moments when I wonder to myself, “Can our patients really get better with this platform? Can we effect positive change and healing? How will our model of mind-body medicine evolve in this space of online treatment?”
Eight weeks ago, one of my longtime patients had a very serious recurrent episode of depression accompanied by passive wishes to no longer live. Then came COVID-19, the lockdown, financial woes, and fears of his loved ones’s premature death. Before we knew we would all be sheltered in place, I had suggested he consider TMS treatment, or even Ketamine, but neither option landed. Despite his own passive wishes for death, he did not want to risk getting the virus by going to the hospital for ECT, so we decided to surround him with care in our IOP at True Life on a daily basis.
We invited his octogenarian father to participate in family therapy with him, we engaged him in our DBT group, we guided him to tune into his internal sensations and state of being through Body Healing and Yoga, and we dove into intensive therapy as well as medication cross-tapers and pharmacy home deliveries. In the early days of this period, I would notice my own anxiety about his fragility. I would obsess about what more we could do to help him get better. He frequently became the main topic of our morning zoom meetings as we brainstormed ways to accelerate his healing journey. The team would celebrate when he seemed to be improving and collectively sigh when his symptoms regressed.
Last week, this patient shared over video chat, “My dad really likes family therapy. I don’t think he’s going to want to stop when my IOP is over.” We looked at each other for a moment in silence, then took a long kundalini breath. “I’m not afraid of him dying anymore,” he whispered, as if realizing this and sharing it all at once. A pause. Then: “I don’t want to die anymore, Dr. Roybal. Do you think these are related?”
There was the moment. That moment when the question emerges from the patient himself, so much richer and fuller than any response from me could ever provide. We’ve worked together long enough that my smile gave me away. He called me out with a smile of his own: ”You’re not going to answer that, are you?”
For the past many weeks, this patient has grown by leaps and bounds, engaging in his job online, having all kinds of creative ideas about his business, and challenging himself in the realm of intimacy and connection. He’ll probably never know how much inspiration he has given all of us at True Life during this time of uncertainty and darkness. He’s transformed from lethargic and hopeless, plagued by constant death wishes, to energetic and innovative, with the strength to take risks. We have been privileged to witness many patients’ healing journeys over the years. But what makes his story so special is that it all happened during the time of COVID-19, where any effort at recovery seemed all the more daunting and therefore all the more profound.
This man has overcome the depths of his isolation during a worldwide pandemic that by nature has separated us and asked us to connect through technology. He has healed old wounds with his father that go back nearly four decades without even being in the same room, not to mention the same city. His insight, energy, and recognition of the sensations in his body have improved greatly. All of this has happened in the confines of his apartment, quarantined from human contact, in front of his computer, not in the healing space at True Life that we have all come to cherish.
His journey has reminded me that healing doesn’t work on our timeline. Love, forgiveness, and connection are transformative. Being seen and accepted for who we are, first and foremost, by ourselves, has that paradoxical power to allow us to change and grow. We hold these truths to be self-evident: The human spirit rises, heals, overcomes, and continues to evolve…even during pandemics, even as we shelter in place, and thankfully, even in front of my eyes in the beautiful journey of this dear patient.
I hope you are all having moments of inspiration in your practice, whether in solo or group practice, at a treatment center or in the hospital. Our community is asking a great deal from healthcare workers and mental health providers during this global health crisis. We have already experienced an uptick in patients with addiction as well as anxiety and depression, and we know more will follow. We’re proud to be part of a vital safety net for people’s psyches and spirits. Thank you to everyone else who’s part of that net. Thank you for your hard work and dedication to health and recovery. What you do does make a difference, even when you don’t get to see the recovery, even when you don’t feel like you are making an impact.
