Practising psychoanalysis and psychotherapy during a time of crisis: coronavirus (COVID-19)  

Updated 2nd April 2020
This page is updated when new information becomes available

This space was created to support our colleagues in China (and now also in other countries) during the coronavirus. You will find here interesting papers and articles to help you think about this crisis. It is open to all our members to participate and contribute with their observations of living and working during a crisis or profound period of instability. Please feel free to contact Silvia Wajnbuch (silviwaj@gmail.com) with your contributions and/or join the discussion at the end of this page or our listserv email group. 


IPA Health Crisis Listserv

All of our members and candidates are welcome to join the listserv email discussion group. A space to exchange experiences, concerns and reflections, and support each other as we face this ongoing public health emergency. 
Subscribe to the list by sending a blank email with no subject and no content within the main body of the email to: 
IPA_HEALTH_CRISIS-SUBSCRIBE-REQUEST@LISTSERV.IPA.WORLD

 
Coronavirus Disease 2019 (COVID-2019) Emergency in Italy
Italian Psychoanalytic Society (SPI): a national toll-free mental health helpline. Starting from 17 March 2020, the Italian Psychoanalytic Society (SPI) has activated a toll-free mental health helpline to support people dealing with worries related to the coronavirus (COVID-2019) outbreak. More information
 

Video conferencing & remote sessions

Advice and guidelines for colleagues in conducting remote therapy sessions

Self isolation and social distancing

Advice for working and confinement at home for long periods of time

Papers & articles

Papers, articles, remote session advice written by our members

Videos

Advice for self isolation and anxiety amongst others

Workbooks

Guides for parents, children and teachers

Journals
Articles and research from medical journals

Comments

You must login to leave a comment.

Posted by:   Dr. Igor Yurievitch Romanov
Posted on:   2020-03-24 19:18 PM
Comments:   [Comment has been deleted by moderator]
Updated By:   Dra. Valeria Nader
Updated On:   2020-03-24 08:49 PM
Reply
Posted by:   Dr. Igor Yurievitch Romanov
Posted on:   2020-03-24 19:19 PM
Comments:   (The original message was written in Russian)

Psychoanalysis in the Coronavirus era: the new atopia "Psychoanalysis, in which the analyst and the analyst are not in the same office, using a phone, Skype or other similar device or application, is atopic in the Greek sense: it is "without space", "without position. Or maybe it would be more correct to say that it is a politope - it does not have one place, but it has several. ...[B]on the current sanitary crisis, the analysis actually works this way. It's a matter of reality checking." S. Jaron. The world-wide epidemic and unprecedented quarantine measures clearly challenge the usual forms of psychoanalytic and psychotherapeutic practice. It is more and more difficult, and often impossible, to organize it in a traditional setting, preserving the unity of place and time of a psychoanalytic meeting. Remote forms of work - telephone, Skype, etc. - become commonplace even for those analysts who have stubbornly resisted them in the past. These trends are not new, but the current situation is likely to spur them. It is likely that these forms of therapeutic/analytical care will become commonplace even after quarantine activities have been completed. It is difficult to imagine how analysts would later be able to deny patients remote sessions in the event of illness, travel, traffic congestion or normal laziness... The spread of remote forms of therapy is already changing the landscape of practice - for example, it is quite easy for novice therapists to start practicing today through special websites, and quite profitable. But, this is how the essence of this practice differs from what we usually consider analytical? Many questions about this are still open. I will formulate a few such questions at a glance. Almost all analysts today share the belief that a successful interpretation or just a therapist's comment should address the situation here and now. It is quite easy to notice (although not easy to correct) the tendency to leave "now," but what to do when two people are actually not "here" - not in the same place? I remember J. Diatkin's report on this topic, in which he emphasized the importance of the commonality of space between the analyst and the analyst - so that they can see the same things, feel the same temperature, etc., and thus catch subtle differences in the perception of the same phenomena. Another question that arises here is the meaning of non-verbal contact and presymbolic forms of communication. Both the analyst and the patient notice gesticulations and postures, hear each other's breathing, voice intonations (cf. musicality of the session, according to Greer, or semiotic (prosodic) components of communication, according to Kristava). As noted by Bion, the real interpretation must penetrate into the realm of feeling, myth and passion. What should be done with feeling? What remains of the fullness of live contact with the voice in the phone? I remember V. Shklovsky's expression: "I live dimly, like in a condom". As noted by D. Anzier, the basic barrier, limitation of psychoanalysis is a ban on touching. In a "sufficiently good" analytical process, this barrier becomes "contact," it allows us to develop the very "transitional space," the space for symbolization or transformation (as it may be called depending on theoretical preferences), in which primitive painful experience can find expressions and be transformed. To what extent is this possible in a situation where the "basic prohibition" on touching by electronic means is reinforced? And what about another ban that goes back to Freud - to satisfaction? Especially if by the latter we mean not only and not so much satisfaction of attraction, but satisfaction of omnipotence - both patient and therapist. My own observations in this area are such that the tension generated by this form of work can increase the psychotic functioning of some patients, while in therapists it leads to some more cognitive and often comforting approaches. I hope these questions will stimulate the discussion. Reality is again imposing its verdict - remote forms of therapy are necessary. The International Psychoanalytical Association recommends them, although it points to limitations - for patients with early trauma and some others this method is not shown. The IPA page provides a resource for exchanging views and materials on this topic.

(Translated with www.DeepL.com/Translator)
Updated By:   Dra. Valeria Nader
Updated On:   2020-03-27 02:20 AM
Reply
Posted by:   Lic. Mónica Vorchheimer
Posted on:   2020-03-21 17:26 PM
Comments:   By Hanni Mann Shalvi from Israel, contribution to COFAP
In Israel, there is a unique emotional response to the pandemic. Israel has experienced threats on its existence, wars and terror attacks from the day of its declaration. Israelis are accustomed to finding themselves in life-threatening situations and know how to cope with these situations. They also experienced reconstruction, rehabilitation and with it the return to routine life. In stressful and life-threatening situations, the family and community bonds become stronger. There is a sense of mutual responsibility, support and holding of each other. An atmosphere that helps Israeli society to cope with these periods maintaining relative mental strength.
At the same time, war situations are characterized by the fact that there is a definite enemy towards whom feelings of anxiety on the one hand and hatred on the other can be directed. In the current situation, Israel finds itself under existential threat but no enemy is seen. The sense of mutual responsibility exists, but there is no one to point out the anger as the focus of the threat. The danger can be from one family member to another. From the children to their parents and grandparents. These feelings can find an outlet towards family members who suddenly find themselves imprisoned at home. In addition, in the face of a real enemy, defense operations can be done allowing to feel less helpless. But in the face of the pandemic, the defense is passive – being locked at home. Behavior that can be experienced as cowardice in the context wars, and may increase anxiety.
In Israel, there are many children and adults who have experienced traumas. As civilians who were exposed to terror attacks, or soldiers who have participated in wars or military operations. This is the case of 40-year-old Amir, who said that since the outbreak of the pandemic he has been imagining piles of bodies in the streets. He is in extreme anxiety, unable to cope. Amir's parents were murdered in a terror attack. The fact that the disease could endanger adults has once again raised the trauma of his parents' murder and this time with intense feelings of guilt that remain unprocessed. Although the conscious content of contemporary anxieties revolves around the pandemics, the processing of guilt over the murder of his parents, and his difficulty with his aggression, have been the focus of the emotional working through, and have relieved some anxiety.
Merav a forty-year-old found herself during this period with severe nightmares in which she suffocated in confined spaces. During therapy sessions, she recalled staying in the sealed room when she was a four-year-old and Israel was at risk of chemical weapons attack from Iraq. Israelis were instructed to enter sealed rooms and put gas masks on their faces. The current directive to stay in homes and not go out, touched that traumatic memory with the emotional baggage of her as a young girl, heightening current anxiety.
Reply
Posted by:   Dr. Morris Stambler
Posted on:   2020-03-19 12:09 PM
Comments:   Child analysts should take a look at zoom. It includes a whiteboard that allows you to interactively doodle with your patients. This is going to be the rebirth of the squiggle game. Born out of the paucity of supplies during World War II we now have to struggle with the new paucity of presence. I have found with my patients that this enlivens things and extends the age range I can work with virtually.
Reply
Posted by:   Lic. Mónica Vorchheimer
Posted on:   2020-03-16 12:47 PM
Comments:   By Susana Muszkat, from Sao Pablo, Member of COFAP, the Couple and Family Committee:
Never before, has the uncertainty principle conceptualized by Janine Puget been so explicitly alive and self explanatory! The certainty of the uncertain.
There are no precedents, therefore there are no safe guidelines that we may rely upon in order to know what one should do to guarantee immunity for him/herself and others. There are, of course, endless informations, recommendations, or even, official determinations. But these, more than being locus of safety, solid grounds to stand on, are rather food for anxiety and panic. Intoxication of the mind and the incapacity to think or to symbolize.
We know, or at least we often affirm we know, that life is uncertain and that death is certain. But times like these, with novelties as unexpected and unprecedented as the ones we are experiencing, strike us in such a way that we are forced to rethink and rearrange all our ways of conducting our lives, and most of all, we, as family and couple analysts, who focus on and value close links, must live under and endorse distances, isolation, when closeness and intimacy become a risk, not metaphorically or symbolically, but very concretely. And where, paradoxically, virtual contact will be preferred, even by us, psychoanalysts, to the live contact we’ve always struggled to defend and maintain with our patients and in our lives.
Reply
Posted by:   Lic. Mónica Vorchheimer
Posted on:   2020-03-15 13:35 PM
Comments:   Dear IPA Colleagues,
Thank you for all this material. I believe that if we share ideas, initiatives, concerns, materials and experiences from all over the world, we will learn from each other and enrich our understanding allowing us to face these terrible novelties. Quarentine demands us to stay connected.
Reply
Posted by:   Lic. Silvia Wajnbuch
Posted on:   2020-03-15 00:10 AM
Comments:   [Comment has been deleted by moderator]
Updated By:   Ms. Rhoda Bawdekar
Updated On:   2020-03-17 03:36 PM
Reply
Posted by:   Lic. Silvia Wajnbuch
Posted on:   2020-03-15 00:09 AM
Comments:   Abrazar el alma

Solos. Con la luz de una laptop. Con la compañía de un frasco de alcohol en gel y un barbijo sobre la mesa. Aislados del resto. Con caricias y besos que contagian. Con un metro de distancia. Con saludos codo con codo.
Me debato entre la mesura y una alarma contenida. Ni subestimar ni entrar en pánico. Y mientras tanto me pregunto qué pasó con nuestro mundo y qué aprenderemos de esta crisis. ¿Aprenderemos? La lección es brutal. Si no la escuchamos es porque estamos muy, pero muy sordos.
Hemos gritado por el calentamiento global, por los derechos de las mujeres, por el respeto a la diversidad, por los femicidios. Y las respuestas fueron tibias. Hemos tenido guerras absurdas (¿hay alguna que no lo sea?), atentados, inundaciones, temblores y terremotos, incendios de proporciones catastróficas. Y seguimos andando sin preguntarnos qué pasa.
¿Es que vamos a seguir sin escuchar?
Un virus invisible nos obliga a cambiar la vida. Y no surge entre los pobres y desplazados ni de las balsas de refugiados. No. Viene en clase ejecutiva para demostrarnos que debajo de la piel somos iguales. Que los millones no nos sirven para nada porque no hay respiradores preferenciales. Nos obliga a “guardarnos”, a no consumir, a no viajar, a no ir a clase, a quedarnos quietos. Nos muestra que somos más pequeños de lo que creíamos. Una herida narcisista, un golpe a nuestra omnipotencia que nos pone contra las cuerdas.
¿Y si escuchamos?
Si en lugar de cuestionar autoridades, de pensar que nos ocultan datos, que los virus salieron de un país de Oriente para hacer una nueva guerra bacteriológica, de seguir debatiendo si es exagerado o no, de enojarnos porque no hay fútbol ni recitales. Si dejamos de especular con subir los precios de lo que necesitamos para protegernos y de mentir para no hacer cuarentenas.
Si aprendemos la lección seremos más fuertes, más sabios, más solidarios. Es tiempo de hacernos el amor con las palabras aunque no podamos tocarnos, de saber si el vecino que está aislado necesita algo y hablarle, al menos, detrás de la puerta, de ser responsables y cuidarnos mucho entre todos. Serán tiempos difíciles. Y estaremos juntos. Como tantas veces. Dejemos de quejarnos por ser argentinos. Cuando hubo situaciones límite allí estuvimos: juntando remedios, ropa y zapatos, haciendo comida en las plazas. Llorando en silencio. Estaremos juntos porque somos esa rara especie de personas que nos peleamos en los tiempos de bonanza y sacamos a relucir nuestro mejor costado en los tiempos de adversidad. Estoy segura de que estaremos a la altura. Lo sé porque te conozco, nos conozco. Esta es nuestra batalla: la de la inmunidad solidaria. Es tiempo de hacer caso a los que saben, de dejar de cuestionar y de dar el ejemplo. Somos un equipo. Si lo enfrentamos juntos nada puede ser tan malo. Vamos a fabricar anticuerpos contra el miedo y la angustia. Y a abrazarnos el alma. Que todavía se puede y no contagia.
Patricia Faur. Escritora
Reply
Posted by:   Dra. Valeria Nader
Posted on:   2020-03-03 22:19 PM
Comments:   Dear all:
This space was created to allow members to write and share comments about living and working during the uncertainty of the coronavirus evolution all around the world.
You are invited to leave comments, questions and opinions. All comments will be moderated, and we ask all contributors to abide by our community standards. Please note, you can choose to subscribe to be notified when new comments have been published.
Thank you,
Valeria Nader - Website Editorial Board member
Reply

New Comment:

Attachment: 
  

Edit Comment:

Attachment:      Delete
   

Subscribe to comments on the page:

Email:
Frequency:
Subscribe:
 
Want to subscribe/unsubscribe on comments? Please click  here