Letter from Pittsburgh

March 28, 2020

Pittsburgh, Pennsylvania, USA

This afternoon, I was seated at my desk when my phone rang, and it was an unfamiliar voice. He introduced himself as a physician at an ICU. A client of mine, a woman with whom I have worked for many years, had been suffering from an extremely rare form of cancer. It had been less than a month since her diagnosis, and now she was dying. As Pittsburgh is in total lockdown, no one is allowed to visit patients in hospitals. I had been talking by phone with her every day. She knew she was dying. Her siblings, torn apart by trauma, violence, and paranoia, were spread all over the country. The doctor said that the nurses knew I had been talking with her every day and she had asked for me. “Can you get here within the hour?” he asked. Yes, but the hospital is closed to visitors. “We don’t want her to die alone. We’ll get you in” was his reply. When I arrived, she was conscious, enormously relieved to see me. I was masked and gloved. The doctor said, “Take off your gloves so she can feel your hands.” I held her hands, and we talked together for an hour as she struggled to hold on to consciousness. She agreed that she was done fighting. Life support was removed, and I sat with her as her life faded away. Since getting home, I’ve been writing on her behalf, in her voice, to her siblings.

I know I am not alone in being thrown into new ways of being with both clients and colleagues. I can only hope we come through this with our professional identities changed.

As I have read the many reflections of our community as we struggle to work under extraordinary circumstances, I have felt the resonances of so many as we have found these unexpected times of frankness and intimacy. We have much to learn. It will take very long time to absorb the implications of these times.

William F. Cornell

April 8, 2020

Pittsburgh, Pennsylvania, USA

I am a somatic psychotherapist—the questions and realities of embodiment do indeed come to the forefront. I think the term “working remotely” is far more accurate in capturing experiential reality than “working virtually.”

We are, in fact, working remotely. We are not in the same room; we are not in one another’s physical presence; and we are deprived of the wealth of sensate, emotional, and nonverbal communications that silently inform, enrich, and enliven our sessions (with a huge nod to Wilma Bucci’s accounting of the place of subsymbolic experience in the psychotherapeutic process). I hear (and myself experience) over and over again the fatigue, exhaustion people experience working the “virtual” realms all day long. It has given me new insights into the anxieties and disconnections my younger clients experience when they spend so much time with the misnamed “social” media. The screens create an illusion of contact. The screens dominate our immediate experience with two-dimensional visual and vocal data. Our receptive tools and capacities are seriously diminished, and I think we are constantly consciously, and unconsciously, trying to fill in the experiential gaps in our contact.

I often hear weary versions of “It’s better than nothing.” But from a somatic perspective, it is the areas of “nothing” that need to be acknowledged. I have found it essential, as these days of remote sessions go on and on, to not pretend that this is good enough, better than nothing. I am finding it essential to acknowledge and inquire about the experiences of absence, what is missing. This is an acknowledgment of elements of our lived realities as we cannot be in close or physical contact with those with whom we are working, with those we love who are now held at a distance. The experience of loss, anxiety, and grief in our sessions is a core aspect of working somatically.

I wrote recently in this forum about my being invited by an ICU doctor to sit with a client of mine who was dying. I was allowed despite the “no visitors” rule. I arrived masked and gloved. The doctor told me to take off my gloves because she needed to feel my skin. He and the nurses knew. We held hands; we spoke; we felt each other. This could not have been done “virtually.” As the medical interventions were turned off and her consciousness waned, she could no longer speak, her eyes closed, but she was still there in her hand. I knew, I felt, her life had ended when her hand left mine.

William F. Cornell