Navigating the Virtual: A Multi-Level Learning Experience

BY CASEY WEITZMAN, M.A., L.M.F.T.

I must admit that I haven’t written in a long time. I guess I haven’t had much to say until now. As a therapist in private practice who primarily works with transgender and non-binary folks in a safe and private space, adjusting to the less personal, less intimate setting of virtual counseling didn’t appeal to me in the least. The first week I thought I couldn’t do it. The bright lighting of the computer screen hurt my eyes. The second week, I felt the same and was afraid I couldn’t do it anymore.

Then, I logged onto some of the online therapist support groups that I occasionally lean on and discovered that so many of my colleagues were experiencing the same things. Conducting telehealth (virtual) counseling is challenging. It takes so much more concentration. It was awkward being in our client’s private spaces. Many therapists are so private, yet clients are curious. Does the therapist have children? Animals? A nice house? Are they wearing sweats? What happens when the dog barks or the children run across the screen, perhaps commenting of things in the background? What if…?

I’ve been invited into clients’ homes and have met their spouses who have been curious about me. It seems organic this way. I’ve met children, cats and dogs as well. We’ve done couple’s therapy in cars and parking lots. I’ve been given tours of their homes and gardens. Clients have taken me on walks while having their therapy. Some of my younger clients have therapy while playing on their computer when they think I’m not noticing. I’ve had clients sing and play instruments which has allowed them a deeper connection. I’ve noticed less make-up and more pajamas and not so styled hair. I think people can tell the same with me. Some admit not showering for a few days. Clients will eat and soak their feet in warm water and smoke cigarettes and sit in their gardens. The closeness of the screen makes it practically impossible to stop starring at each other. For many of my transgender and non-binary people who are not out at work, this has given them the opportunity to dress as they like, relax and not struggle with the everyday experience of their dysphoria. I’ve been able to support and encourage clients to make difficult calls and appointments with transgender health programs, heart doctors and it seems easier for them as they do it from the comforts of their own homes.

On the same therapist support sites, many worried about losing clients. It happens, and that’s part of the experience. Clients have to work harder in this forum or therapy won’t work. Similarly, therapists have to work harder as we have to make extra effort to listen and try look at our clients in the eyes — when we’re not always sure where to look on the screen.

For the past several months, I’ve learned so much about my clients by having this experience. Telehealth can be so frustrating, at times, due to the momentary, sudden internet outages. It’s been a learning experience which has forced me to learn how to utilize new software and other resources — things I’ve always wanted to do, but never had the time (LOL). What I know for sure is I love my work! I’ve learned how to make it more enjoyable and more fun now. I appreciate and I’m embracing telehealth when necessary, but I can’t wait to drive away from the quarantine to my brand new updated offices where I get to see my clients in person. I know it’s not going to be today or tomorrow, but it will be one day — I hope. If/when that happens, we will sanitize, keep social distancing, wear masks, and not come into the office when sick.

I look forward to experiencing some sense of normal.

— Casey

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