“Hello, Can You Hear Me?”: Therapy on Zoom

Isolation, mass illness, death, unemployment, and closed schools have moved people out of the initial phase of panic and anxiety of what is to come to the demoralized place of what has arrived—nothingness. 

Nothingness is a different psychological beast than anxiety and fear. It lacks the energy for mobilizing resources, taking action, or even taking flight. 

Nothingness shuts down the mind, eliminating our capacity to solve problems, care for ourselves, and adapt to this new way of living. 

Nothingness leaves us powerless, helpless, and dissolved of hope for any meaningful change in our lives. 

Nothingness turns people silent. And silence is dangerous.  

My 9:00 AM patient whispers almost inaudibly that she has nothing to say. My 11:00 AM patient doesn’t know what to feel, and my 6:00 PM patient is at a loss of what to expect for his future.  

My 10:00 AM patient slept through his session again this week, my 1:00 PM patient doesn’t know how many glasses of wine she is drinking each night, my 4:00 PM patient calls me high again on marijuana. And all of my patients hate how much they are eating.

How do we understand these human experiences?

As our economy has receded, so have our minds. 

We’ve begun to turn our minds off to a place that now feels too terrible to bear, in response to the overwhelming horror of what’s happening in our world and within each of our lives, But when we turn our minds off to the world, we suffer the collateral damage of turning our minds off to ourselves as well. We disconnect from our own experiences—silencing our capacity to think, feel, and express ourselves. 

My 2:00 PM patient described it aptly when she said, “I don’t feel myself pick up the tenth cigarette of the day. I am just inhaling it”. 

For many of us, it’s now not about protecting ourselves from the arrival of nothingness, but rather now trying to claw our way out of the nothingness that is already here. 

Our initial phase of response was panicked survival mode. Stockpiling supplies. Frantically watching the news. Fleeing cities. But as days turned to months, our bodies exhausted themselves of anxiety, leaving nothingness to take over.

Nothingness feels numb, deadened, and trancelike. We find ourselves drinking, eating, smoking, and sleeping our way through our lives. 

My 2:00 PM patient doesn’t realize she’s picking up her tenth cigarette of the day because as the world has gone into seclusion, she has lost something essential but easily overlooked: a witness to her life. 

Without witnesses, our lives become meaningless. We begin to feel as if we don’t matter. 

Each of us needs a witness to our fugue-like states, where we find ourselves drifting unnoticed from one action to another as our days blur together. A witness changes our actions from mere efforts to survive each day to the hope for adapting and developing new ways to live in this unrecognized world. 

We need our minds turned back on to begin to alter our behavior and live a life we can recognize. But we need each other to do this. Our minds cannot develop and grow, without another’s mind witnessing the very self we no longer can see ourselves. 

Just as the mind recedes in isolation, it expands in company. So, we need to be each other’s witness to our unthinkable and unimaginable minds—the minds that are stuck in nothingness. 

This week my 1:00 PM patient has noticed that she feels less despairing. She’s not sure why, but she has also realized she hasn’t had much to drink. She doesn’t know what to make of this, but I do. She needed my mind to help pull her out of the deep hole of nothingness. In talking to me and letting me witness her alcohol-filled days, she could begin to see herself. 

Therapists are trained witnesses to the unimaginable states of being, helping people to weave new experiences into their constricted minds. Therapists not only help with symptoms of distress, but we work closely to track and reflect back to people the minds that they have neglected.  

But we can all do some version of this for each other, in listening and watching closely (on video sometimes) how someone has let their sentence trail off, how they’ve picked up their third glass of wine of the evening, or how someone’s clothing hasn’t changed in two days.    

The world needs a witness as a voice on the other end to answer the distress call, “Hello, can you hear me?”

We need to say clearly to each other, “Yes, I hear you, even when you can’t hear yourself” 

In our collective witnessing of each other, we can slowly grow our minds back to functioning, thinking, and, in time, the hope of going on being. 

Alexis Tomarken, Ph.D., is a clinical psychologist in New York City and a candidate at NYU’s Postdoctoral Program in Psychoanalysis. She’s on the Advisory Board of the American Mental Health Foundation and writes on loss and trauma.