Published: 10th October 2020
Why more Indians have turned to seeing their therapists online in the middle of the pandemic
COVID has forced many services to go online. This includes therapy too. We asked a few youngsters what they felt about it
For Kaira, everything appeared better that day. The speed at which the Goan breeze gently blew through her hair behind her ears. The two puppies behind a black gate on her way home were suddenly cuter. She smiled at them and walked, following the wind's trail, swinging her denim jacket up in the air. She even skipped and hopped her way home like someone out of a fable. There was no one to watch. She may not have cared even if anyone watched.
Kaira was on her way home from her therapist's clinic. For the first time, probably in months or even years, she felt like a million bucks. She wanted to desperately hold on to that feeling. In case you haven't realised it yet, Kaira is not a real person. She is only a figment of Gauri Shinde's imagination and was portrayed by Alia Bhatt in Shinde's film Dear Zindagi.
A therapy session in Dear Zindagi
But Manasa relates a lot to Kaira. She recalls how she always had a similar smile on her face, every week she left her therapist's clinic in Chennai's Mylapore. "I would look forward to those sessions. They made me feel so much better and just like Kaira, I hopped a step every time I left my therapist's clinic," says this 24-year-old.
It has been six months since Manasa visited her therapist's clinic. She calls it a cozy place with pleasant interiors, potted indoor plants, pretty cushions and a calming earthly aroma. "Scents and incense usually irritate me. But here, it was all different. The olfactory and aesthetic impact of that room made therapy even more effective," she says. Sometimes, her therapist brought kittens for Manasa to play with. She loves cats. On other days, they drank cups of tea together or shared a fruit. "I miss all of that these days. Now, I attend my sessions regularly with my therapist over Skype calls," she says.
Manasa's sessions are now held online
Manasa is one of hundreds of people who had to make a sudden switch from face-to-face therapy to online sessions when the pandemic hit. Even though six months have passed, she still finds it difficult to cope with the virtual therapy sessions and seeing her therapist in a tiny rectangular box. "Way back in February, my therapist had an intuition that COVID was here to stay. So she shut her clinic weeks before the actual lockdown and had us switch to Skype sessions," she says.
The not-so-easy switch
It was in February 2019 that Manasa started therapy. She remembers jumping in a cab right after a busy day at work to her happy place. She always went prepared for these sessions. In a notebook, she noted down specific points that she wanted to talk about on that particular day. "For me, therapy was more like meeting a friend who would listen to me. My therapist has a very calming face. I share a close bond with her. We often greeted each other with hugs. To be honest, that is the only hug that I miss these days," she shares.
These days, Manasa tells us how she sits in an enclosed room with her laptop during the sessions, she says that a few aspects cannot recreate in these virtual sessions. "There are certain sessions where I have to lie down straight with my eyes closed and meditate, by only listening to her voice. This becomes quite difficult when I'm home. There is always a chance that someone would barge in or knock on the door. It is not a space for the two of us," she says.
For Manasa, the olfactory and aesthetic impact of that room made therapy even more effective
Cara Lisette, a mental health blogger from England, agrees. "I miss not being in the clinic and not sharing a room with my therapist, especially as it’s hard to read body language," she says. Someone who switched to online sessions after the UK went under lockdown in March, she does not hope to have her regular sessions back anytime soon.
But that's not to say that everyone feels that way.
More than a couple of thousand kilometres away from Manasa, in Delhi, lives writer Mahima Kukreja. Mahima's therapist lives in Mumbai. Given the distance, she thinks of online sessions as nothing less than a boon. "Online video consultations and therapy sessions are great alternatives to actual therapy sessions," she says.
Over two years ago, Mahima started curating a list of therapists across the country, with their contact details. She has also mentioned therapists who conduct these sessions online, in that list. "Since the lockdown began, a lot more people have been reaching out to me, seeking suggestions about therapists. Thanks to online sessions, a lot more people have access to therapy now," she says. Mahima also brings up the real problem of accessibility here. "A lot of them who reach out to me are LGBTQ youth. Not many are lucky enough to find queer affirmative therapists in their towns. This way, they can access a good therapist, even if they are not in close proximity," she says.
Online therapy is helping a lot of LGBTQIA+ youth
However, not everyone made the switch to online therapy. For instance, Rina*, a former journalist from Chennai took the risk of skipping therapy during the lockdown. "I know, it has its own repercussions, but it simply doesn't work for me. What is the point of trying out something that worsens my condition," says this 27-year-old, who suffers from depression and anxiety. She also tried out a few mental health apps, which did not work well.
404 error. Dammit
Both Mahima and Manasa, however, agree that technical glitches are the vilest antagonist when it comes to online therapy. While Manasa hates it when she gets to see her therapist's pixelated face, Mahima says that privilege plays a crucial role in terms of accessibility to good internet. Psychiatrist Dr Arun B Nair says the same thing. "An uninterrupted internet connection is necessary. What if the patient is sharing a piece of sensitive information or is breaking down and the connection goes off? The session may fail if the therapist fails to help the client out at the vital moment," he says.
An upward curve
A report by the Indian Psychiatric Society stated that mental health issues among Indians have risen by 20 per cent during the lockdown. At the same time, stress and panic attacks have increased by over 35 per cent. At a time like this, it is almost impossible for people to skip therapy. Reports and anecdotes suggest that during the lockdown, there has been a surge in the number of people who seek therapy. Manasa tells us how her therapist was so burnt out attending sessions back to back, that she had to take a month-long break.
Stress and panic attacks have increased by over 35 per cent
However, Saras Bhaskar, Counselling Psychologist from Chennai says that the surge in requests is also because people now have more time for self-care. "To be honest, my appointments are full for a month. I conduct these sessions via Skype so that it enables me to see the faces of people," she says. Even though she finds it quite comfortable, there are obvious concerns. "I do not know if the sessions are getting recorded. Neither the therapist nor the client is allowed to record sessions without consent," she says.
Is this the only way forward?
Arun points out an important factor that face-to-face sessions may lack, in COVID times. "Doctors interact with a lot of people and are mandated to wear masks and face shields. Patients too wear masks and this makes it difficult for us to make an analysis on the basis of their expressions. However, this problem doesn't arise during virtual sessions," he says. "At the same time, therapists have to make sure that the light settings in the room are perfect and the client gets to see their face well. This should not hamper the conversation," he adds.
Masks make face to face interaction quite difficult
At the same time, he feels that people take more time to get comfortable and open up in virtual sessions. "Also, therapists have to be careful while conducting online sessions for patients with psychotic conditions. They must make sure that they don't provoke the patient," he says.
Making the most of now
At the same time, Manasa, who has now made peace with the fact that online therapy sessions may continue for a while. Even if the face to face sessions restart, she wonders if things will ever be the same and if she can easily make a switch between virtual to real. However, for the time being, she has made a list of things that she would try out before and after therapy. "I make it a point to dress up for therapy. It usually happens early in the morning and since I am home, I can be in my pyjamas, but I want therapy to make me feel good," she says. "Right after this, I take a long relaxing shower and then eat something nice," she says.
The switch was quick and unprecedented. However, people around us are taking that extra effort and making the best of technology. But at the same time, they do know that therapy, like any other medical consultation is necessary.
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*Name changed on request