With a click of my mouse, I admit my psychiatry patients into my house.
Not my officemy house.
They cantseemy house because I use aZoombackground that blocks the environment behind me and sometimes makes my hands disappear.
CACTUS Creative Studio/Adobe Stock
(Zoom backgrounds are weird like that.)
Dont get me wrong: I completely understand whyteletherapyis a fantastic tool.
It magnifies access tomental health resourcesfor many people, which is crucial given how scarce these resources already are.
Its also great for people who live far away from their therapists.
Driving hours to see a therapist for less than an hour doesnt make sense.
But, like everything, teletherapy is not for everyone.
Other people cant afford to have devices that allow for video calls or dont have access to Wi-Fi.
An intact therapy frame
No Zoom background can block out my dog barking.
Or a delivery person knocking on my door.
Or sounds from my neighbors.
When my dog barks, for example, the frame doesnt feel as secure anymore.
The therapy session becomes more about me than my patient.
The possibility of the internet breaking the frame is another added anxiety for me.
Chitchat
Teletherapy is especiallyanxiety-inducingwith new patients thanks to the lack of chitchat.
Its a lot harder to do that when someone just pops up on my screen.
It often feels kind of awkward or like we missed a step.
The complete picture is missing.
I also find myself distracted when patients do things like eat or smoke cigarettes during a visit.
Sometimes its me shifting my own body language in response to their words or handing them a tissue.
I have even tried saying, If I were there, I would get you a tissue right now.
Trust me, that does not land the same.
I write, and I listen to them talk.
I do not use a computer until I need to order medication at the end of the visit.
I do this very purposefully.
I dont like how looking at the screen can create a barrier in the room with a patient.
I also dont like being on a computer all day.
Obviously, right now, all of my work happens on my computer screen, essentially uninterrupted.
I will do this even if Im going to then be two minutes late for the next person.
Online interactions arent the same.
I really, sincerely miss seeing humans, especially my patients.
Honestly, Id much rather be there in person for that too.
So…should we talk about that?
I know its not ideal.
