Don’t clam up. Say what’s on your mind

For Geetanjali Kumar, a psychologist in Delhi, the process of examining and getting to know her patients would start before their first consultation. “I often observed them in the waiting area — body language, expressions, gestures can say as much as words,” she says.

Which is why she was initially hesitant to counsel patients virtually, during the lockdown, and especially reluctant to take on new cases.

But as conditions intensified and her patients needed her even more than usual, she decided it was worth a shot. Now, she admits, most patients have adapted well to phone and video chats. “When they are using any means available to reach out, it means their need is great and so is their commitment,” she says. “A new patient who reached out to me during this time had a set of questions ready, because she wanted to understand how remote therapy would work. Some existing clients are enjoying the increased informality and the convenience of speaking from their own homes, at a time that is convenient to them.”

Of course, this does not take into account people whose home environments are not conducive to therapy — whether in terms of being overcrowded or filled with stressors and even abuse. It does not take into account those who need to discuss subjects their families may not even know of — alternate sexuality, personal issues or issues with the family itself.

Still, in a time when even the calmest among us are having trouble sleeping, and then struggling to find a reason to get out of bed; when anxiety over life in lockdown is superseded by anxiety over what will come next, it helps to have help just a phone call away.

It’s a phone call more and more are people are finding themselves in need of. For instance, the Mumbai-based mental health facility Mpower, which launched its helpline (see box for numbers) in partnership with the Maharashtra government and BMC amid the lockdown, on April 3, says it has received 42,000 calls so far.

Ups and downs

“A few patients have said they feel the ambience of a clinic helps them open up more,” says Sapna Bangar, psychiatrist and head of Mpower. “And of course remote therapy is difficult for people with relationship issues. With everyone at home during lockdown, they feel they can’t talk freely because someone else might hear them, or be listening.”

Technology can also pose a challenge. “It can be particularly hard to have sound and networks waver when you’re discussing something sensitive, or feel you are near breaking point. There are few things harder than repeating something you had trouble verbalising in the first place,” says Delhi-based psychiatrist Sunil Mittal.

It is also a good idea, adds Kumar, for the therapist to record his or her voice and play it back before they begin virtual sessions, so they know if they need to work on their voice and the tone to make it more reassuring for their patients.

Longstanding patients are nonetheless waiting to get back to offline sessions. “I miss the consultation room,” says a 22-year-old Delhi student who’s been seeing a counsellor for three years. “I felt secure there. At home, even in my room, I sometimes worry about my family overhearing the personal stuff that I want to discuss with my therapist.”

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