What We Left Behind

My mind keeps returning to an image of myself sitting in my chair at the office—my therapist chair—in March 2023. Only the dim winter sun and the murmur of passing cars filtered in through the window on my left. Inside, the air purifier hummed. The couch across from me had been left empty when my patient stood to leave a few minutes before. I had closed the door behind her, then moved to my desk to retrieve my phone. Anticipating an unscheduled hour, I’d returned to my chair and lit up the screen, searching without thinking.

 

There’s something faintly shameful and off-kilter about this memory, though it’s also banal. Recalling it, I feel the emptiness of the room, the quiet after the vivacity of my previous patient. A moment before, we had been intent on her concerns about the future: her conflicting desires, her sense of powerlessness in the face of larger economic and political forces, her self-doubt, her hopes. The pandemic had upended her life in ways that she’d mostly welcomed, even as the virus scared her. She’d begun to question the premises of her life more deeply than ever before and to feel profound uncertainty about her next phase. Our hour together had been rich and full, if somewhat difficult. And then she was gone. 

 

Years ago, I would have turned to my notebook to scribble a few phrases from the session. But in this memory, I turned to the phone instead, and the separation from her was handled through diversion instead of reflection. It had become a habit. On that afternoon, though, sitting in my chair, I became aware of a feeling of dissonance as I scrolled, and I pulled my attention away from the screen, back into myself. I experienced a sense of loneliness and the vague wish for human contact that had been pushing my search.

 

That’s where the shame came in: shame about my need for contact and the way I was seeking it, shame that I had abandoned my patient and my work so quickly and impulsively. Judgments were surfacing about what I’m allowed to feel and do as a therapist—in my role, my chair. Yet it felt like I was contacting something important, something that hadn’t always been there, about the ways that my own needs had come to be sidelined chronically. Sometimes those needs were stirred at the end of my time with patients. Now I could sense my anger too, and helplessness about the predicament of my isolation. But surely others are also feeling these things, alone in their therapy chairs. How did we get here, and why don’t we talk about it?

 

That March afternoon echoes with earlier memories. Precisely three years before, in that same chair, I was working through what turned out to be the final week of in-person sessions; questions about the “novel coronavirus” were beginning to haunt my time with people. As I look back now, my images of those days—sitting with patients in my eleventh-floor office in downtown Chicago—are shadowed by my knowledge of what we were about to lose. 

 

Over the course of those tense days in March 2020, questions turned to certainty: all plans needed to change. The next work week found me at home, as I began listening to patients through earbuds, huddled in the spare room, trying to ignore the sound of my three-year-old running up and down the hallway just outside the door. New worries entered the sessions, as patients struggled with uncertainty about their safety, their jobs, and their social responsibility in this time of collective crisis. I steadied myself with the task of re-creating our holding space, as if trying to listen intently on a lifeboat. And the container did seem to hold, miraculously, for them and for me, in session after session. But then a patient would share some disturbing piece of pandemic news, and my panic would rise as I remembered that I, too, was adrift on these stormy seas. I would fight the impulse to end the session and research this new information, to keep myself and my loved ones safe.

 

My phone was a lifeline. It kept the work going during a time when therapeutic relationships felt more crucial than ever. It connected me to family, friends, and mentors—we ran things by one another, reassuring and restabilizing again and again. And, of course, the phone and the internet brought me information. I remember watching, in those early weeks, a video of a physician in the Covid ward at a hospital somewhere in New York—Manhattan, I think. He acknowledged the weeks of overwhelm: patients on gurneys in hallways, unable to breathe; patients dying and being wheeled out to make room for more—all in an atmosphere of uncertainty about how this virus was transmitted and whether he would contract it and bring it home to his family. Ultimately, though, his video was a message of hope, based on a growing sense that, in his ward, their safety protocols were working; they were learning how to protect themselves. I held on to his words in the weeks that followed, as they intimated that this chaos might somehow be organized into a path forward. We wouldn’t always have to live this way.

 

My rush to safety, in March 2020, meant retreating from face-to-face contact—bodies in a room. I was extremely lucky to be able to protect myself that way, and yet, when I think of it now, there’s a pulse of feeling, like a buried sob. 

 

I remember the life I left behind, where most of my human contact was in person. I hurried to and from meetings, greeted my friend and suitemate between sessions, tensed with faint nervousness when approaching a psychoanalytic lecture space, then softened when I saw familiar faces. Hour after hour, patients would visit my office, with me hosting them, in a way, implicitly welcoming them. When I think of it now, I understand the buried sob is about sudden absence, about people disappearing behind closed doors. It reminds me of the abandonment some clients felt when I announced we would begin meeting by phone. 

 

I return to the image of being alone in my therapy chair—in March 2023. My next session was in an hour, with a longtime patient calling from his parents’ home far outside the city, where he had moved at the beginning of the pandemic. It was my last session of the day. I decided to pack up and head home to take his phone call from there. I would do my own therapy appointment from home, too, so that I could get to my child’s school just as it let out.

 

These phone sessions still feel complicated, though they’ve changed from those tumultuous early days. Now there can be something delicious about being home to do what used to require more separation from my life there. Like I’m stealing something back for myself. And yet there’s an odd feeling about the whole thing, a split I feel during those calls. Part of me is focused intently on my patient, and another is rooted in my surroundings, my private space. My gaze may wander to the dusty corner of the shelf, the spine of the book I never got around to finishing, bright new maple leaves quivering beyond the window. With video sessions, too, and online meetings and lectures, the juxtaposition permeates the experience and strains my attention. We are together, sometimes in extraordinarily meaningful ways, and yet we are not together at all. The distance is rarely named.

 

Talking with colleagues, I hear us negotiating these splits—and adjusting the therapeutic frame—according to our own circumstances and leanings. In our decisions about meeting virtually, we consider the needs of our patients or meeting attendees but also our own concerns about health, finances, stressful commutes, domestic obligations, carbon footprints, etc. And then there are less-tangible pulls. At an in-person lecture, for example, we must face social differences, with their hierarchies and exclusions, an effort that demands more of us depending on our position in the community. When I attend the lecture from home, I can turn off my camera and sit in my socks. Something in me can relax. Maybe, for many who were able to spend more time at home during the pandemic, when we felt relatively safe there, certain neglected longings were stirred. The possibility of downplaying our human needs—ever present in our work—only increased under the countless pressures of these turbulent years. In certain situations, we may stay home as a way of rebalancing or even acting out our resentment. And the screen has come to seem good enough.

 

Truth be told, I was drawn out of my complacency after that first pandemic year by certain patients who kept wondering about meeting in person. I had been looking forward to finding an office closer to home, but after the first wave of vaccinations and the opening of the long-awaited Chicago summer, something in me seemed reluctant to “return to work” fully. Yet these patients seemed to know what they needed. Indeed, once I secured a suite, and we began sitting together again, I recognized what we had been missing. Even when we wore masks in those early months, our felt sense of one another deepened, and it opened more room for both conflict and silence. I remembered that I do this work, in part, to spend time with people in particular ways. There’s something about the dance between two attentive mammals in a room.

 

Still, the dilemmas continue. Many of us are living with the echoes of unmourned losses and a flight to technology that began three years ago. We are left with forms of insularity and of distance communication that are partly chosen and partly habits we developed to cope. When we find ourselves in a dilemma about meeting or canceling, for example, we may opt for a virtual session without acknowledging the meanings and impacts of that choice. As a field, we seem to be neglecting these experiences, occluding them from our analytic view. And it may be difficult for that conversation to emerge spontaneously when Zoom is the main space for contacting acquaintances. We don’t mingle much anymore.

 

There are needs that seem downplayed in all this, including the need to engage in embodied ways with people and concerns outside our immediate circle. For my part, I miss in-person psychoanalytic spaces, even as I appreciate what has been born from the gaps. I worry we are forgetting the significance of certain ways of being together that, as a community, we have re-created with one another year after year, decade after decade. Who would have thought, before the pandemic, that we could forget such a thing? Perhaps a form of dissociation is at work, protecting us from the sense of threat that forced our adaptations.

 

I wonder what might come of remembering and then opening to our feelings about what we have lost. We might have to face responses we feel we’re not supposed to have and tensions that arise from our shifts in priorities and circumstances. We may come to recognize our longings for connection, our reluctance to connect, and the structural issues in our organizations that shape who connects with whom. But we might also be able to imagine new ways of working with all this, both in session and in collaboration with one another. First, though, we need to look back to what we left behind.