Working Online During the Contemporary COVID-19 Pandemic1

Within the psychoanalytic school there has been substantial and ongoing debate about the efficacy of teleanalysis. However, as a result of the current COVID-19 pandemic and the online work with which the Jungian analytic community has now had to engage, this paper initially focuses on analysts’ actual experiences of working by teleanalysis. These experiences highlight a range of issues like “Zoom fatigue”, “online disinhibition”, dissonance, confidentiality, the frame and working with new patients. Alongside these issues, there were ample experiences by analysts of both productive psychotherapy apace with analytic work involving transference and countertransference phenomena, all indicating that a genuine and good enough analytic process can occur with teleanalysis. An overview of the research and literature both prior to the pandemic and as a result of it, confirms the validity of these experiences so long as analysts are cognizant of the specifics of such an online modality. Conclusions to do with the question, “what have we learned?”, alongside training, ethics and supervision issues are subsequently discussed.     

Discussing the therapeutic setting in child and adolescent psychoanalytic psychotherapy

The aim of this paper is to contribute to a debate on the particular characteristics of the therapeutic setting in child and adolescent psychoanalytic psychotherapy and its differences from the setting in adult therapy. In our opinion, there is a fundamental difference between these two, as in child and adolescent psychotherapy two distinct aspects co-exist and in some areas, overlap. In this paper, we attempt to delineate these two aspects, following Green’s division of the analytical setting into the active matrix and the casing. We propose that in child and adolescent psychotherapy the therapeutic contract, the active matrix, concerning the necessary conditions for making a therapy psychoanalytic – namely, the therapist’s free-floating attention and the patient’s free associations – is agreed between the therapist and the child/adolescent. We argue that in contrast, the contract regarding the casing – the timings of sessions, the fees and so on – is agreed primarily with the parents or carers of the child/adolescent. Ruptures and possible modifications in both the matrix and the casing of the setting are discussed through the presentation of clinical material.     

Helping Couples in the Shadow of COVID-19

The pandemic caused by the SARS-CoV-2 virus (coronavirus) and the associated illness, COVID-19, has caused a level of worldwide upheaval unlike any most people now living have seen in their lifetimes. This crisis affects people in their most important, committed, and intimate relationships. Although this crisis has damaged the health and well-being of individuals, crushed economies, and led to an extensive period of uncertainty about the future, there may also be positive outcomes in the motivation people have to protect their relationships. In this paper, we focus on strategies that therapists and relationship educators can use to help couples preserve and protect their relationships during such a time. We describe four foundations of safety that allow relationships to thrive: physical, emotional, commitment, and community. We then highlight three keys from our body of work that can help guide individuals and couples in protecting their relationships on a day-to-day and moment-to-moment basis: (1) decide, don’t slide; (2) make it safe to connect; (3) do your part.     

Working online due to the COVID-19 pandemic: a research and literature review

Given the contemporary situation of many analysts in the world now being forced to work online due to the effects of the COVID-19 pandemic, it is important to review the working online issue. Substantial debate over previous years has questioned whether a genuine analytic process can unfold through online work. This debate is reviewed with the conclusion that such a process is not necessarily precluded. Research outcomes are then reviewed to highlight those things that can facilitate positive outcomes when working online. These cover the ‘online disinhibition effect’, the therapeutic alliance, particular ways of using the screen, focussing on trauma, the importance of self-awareness, knowing the predictors of mental health, certain potential positives of isolation/quarantine and psychotherapy interventions that may be currently needed. Final recommendations and suggestions are then presented as in the diagnosis issue, professional development and guidelines to do with practical and ethical considerations.     

Clinical experiences during the COVID-19 pandemic

Most of the clinical experiences discussed in this article arose from monthly Zoom meetings at Rome’s Italian Centre of Analytical Psychology (CIPA). We set up a discussion group in April 2020, one month after lockdown began in Italy, and these monthly online meetings continue to this day. All senior analysts and analysts-in-training at Rome’s CIPA, whose backgrounds range from child and adolescent psychotherapy to adult psychotherapy and analysis, to sandplay therapy and medicine and psychiatry, have been participating in these meetings. The group discussions focus on the present time and its impact on us, as well as on our relationships with patients. By further developing these reflections during the lockdown in Italy (9 March - 3 May 2020), it is fair to ask whether a sense of unreality, depersonalization, or derealization has occurred, either in the therapist or patient, and if so, whether it is possible that therapists miss the human contact more than clients. We will mainly refer to clinical and personal experiences as our most precious guidelines.     

Implicit States of Connectivity in the Clinical Practice of Jungian Psychoanalysis and Andean Shamanism

This paper will describe the spiritual states of “oneness” experienced by Andean shamans in relation to oceanic states in early infancy and working with trauma in Jungian analysis. The author’s work exploring implicit energetic experience with Andean shamans will be referenced with comparisons made to depth psychology, in both theory and in practice. Definitions of Q’echua terms describing different psychic meditative states that Andean shamans enter into will be provided as Andean medicine people have a much more developed language for conceptualizing these experiences. A clinical vignette will be presented that demonstrates how the spaces of implicit connection that occur between an analyst and analysand in the analytic setting can be a catalyst for healing.     

COVID-19, precarity and loneliness

In this paper I discuss Jungian psychological work of the trauma and loss experienced in reaction to COVID-19 with a man who represents a clinical composite. The issues of precarity, a concept used by the philosopher Judith Butler, are combined with the notions of lack and absence of French psychoanalyst André Green. The psychological and societal situation of precarity aroused the man’s childhood issues that were long repressed. The loneliness, isolation and death from COVID-19 mirrored his personal and the collective responses to the disaster from this global pandemic. He felt on the edge of collapse as what he knew of his world crashed and he found himself unable to cope. The subsequent Jungian work taking place through the virtual computer screen was taxing and restorative simultaneously for both analyst and analysand.     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

Using robots at work during the COVID-19 crisis evokes passion decay: Evidence from field and experimental studies

The growing trend of introducing robots into employees' work lives has become increasingly salient during the global COVID-19 pandemic. In light of this pandemic, it is likely that organisational decision-makers are seeing value in coupling employees with robots for both efficiency- and health-related reasons. An unintended consequence of this coupling, however, may be an increased level of work routinisation and standardisation. We draw primarily from the model of passion decay from the relationship and clinical psychology literature to develop theory and test a model arguing that passion decays as employees increasingly interact with robots for their work activities. We demonstrate that this passion decay leads to an increase of withdrawal behaviour from both the domains of work and family. Drawing further from the model of passion decay, we reveal that employees higher in openness to experience are less likely to suffer from passion decay upon more frequent interactions with robots in the course of work. Across a multi-source, multi-wave field study conducted in Hong Kong (Study 1) and a simulation-based experiment conducted in the United States (Study 2), our hypotheses received support. Theoretical and practical implications are discussed.     

Supporting Romantic Relationships During COVID-19 Using Virtual Couple Therapy

The novel coronavirus disease pandemic (COVID-19) has profoundly impacted people’s lives, resulting in economic turmoil, death and suffering, and drastic changes to everyday life. The adjustment and strain of such challenges can spill over into couples’ relationship processes, including how partners spend time together, talk to one another, and manage conflict. Drawing from our experiences conducting virtual couple therapy (VCT) in a university-based training clinic and community-based clinic, as well as themes from an informal survey of 29 couple therapy clinicians, the current paper discusses the unique challenges that couples face in therapy during COVID-19. Such challenges include renegotiating quality time together, navigating less personal space and time alone, experiencing individual anxiety and stress prompted by the pandemic, and increases in conflict. We discuss our clinical recommendations for addressing these challenges for couples and utilize clinical case examples to illustrate our points. Despite these challenges, we also comment on several positive aspects of COVID-19 on couple relationships. Guided by these considerations and recommendations, our observations suggest that clinicians can effectively support couples’ growth and progress using VCT during COVID-19.     

Psychological implications of the COVID-19 pandemic around the world: Introduction to the special issue

Although psychological researchers have long studied the implications of major crises, the outbreak and spread of the COVID-19 pandemic have confronted the global community of psychologists and psychological researchers with new challenges. This special issue contributes to the growing empirical literature on the immediate psychological implications of the COVID-19 pandemic. We present and discuss diverse work from authors that followed our call for papers in May 2020, shortly after the World Health Organisation declared COVID-19 a global pandemic. The studies focus on the early phases of the pandemic by addressing (a) implications of the pandemic for psychological well-being and mental health, (b) psychological effects of lockdown scenarios as well as (c) individual compliance with COVID-19 prevention and intervention measures. We conclude by highlighting the need for new research efforts, with a special focus on low- and middle-income regions, international research collaborations and cross-cultural research designs.     

Case history of Farida: A year of psychotherapy with a girl who said she was sexually abused

This paper discusses how thinking about a playroom involves our thinking about the setting in psychoanalytical work with children in general - the physical as well as the human aspects - and how this encourages us to rethink some of the basic aims in psychoanalytic work. The paper describes the importance of the setting being such as to help the therapist to have the freedom to think and to feel what is going on in the child and himself. Links are then made with aspects of transference and counter-transference, and brief examples given.     

When work came home: Formation of feeling rules in the context of a pandemic

The shift of middle-class jobs to home settings, which occurred as a result of COVID-19 health measures that also closed schools and daycares, introduced dynamic changes to everyday life. We investigate these changes drawing on data from our study in which participants in Nova Scotia, Canada, who were working at home due to the pandemic, wrote journal entries in response to weekly prompts. Participants not only documented changes to their routines and challenges of managing work and parenting simultaneously and in the same physical space, but also reflected on their conflicted emotions about life during the pandemic and their vision for life as things return to “normal.” Their narratives prompt us to consider these experiences and emotions in relation to Arlie Hochschild's scholarship on feeling rules, emotion work, and gender and work more broadly. We find that from our participants’ struggle to meet existing expectations on activities and emotion while simultaneously managing new sets of protocols and feeling rules what emerges is a resistance to norms of busyness, productivity, and exhaustion.     

Essential anxiety: COVID-19 in analytic practice

This paper explores the impact of the COVID-19 pandemic on my relationship with analysands and my inner world. I reflect on the role of the archetypal Self during times of existential anxiety that may lead to an experience of ‘essential anxiety’. This term refers to a meeting by a fearful ego with an inward recognition of the Self, when faced with threat. The efforts to curb the spread of the pandemic changed our ways of life, while the virus itself threatened our existence in debilitating or outright destructive ways. But what also came into view, in sessions of analysis and supervision, was the creative instinct, and a celebration of life. The soul-to-soul relationship, and the connection with images of the archetypal Self, made the experience of existential anxiety at times an essential experience that facilitated psychological growth. I discuss some advantages of on-line Jungian analysis where, despite distance and partial view, the body still serves as container to hold important psychological material, conferring a sense of wholeness for analyst and analysand. The COVID-19 crisis is terrible and terrifying but it also provides an opportunity for self-regulation and individuation.     

Sitting In: The Experience of Learning and Practicing Family Therapy through Being a Co-Therapist in Hong Kong

This article explores family therapy trainees’ subjective experiences of working as cotherapists with a supervisory-level therapist in a Chinese context, regarding their perceptions of and positioning in it and also their opinions on the benefits and/or pitfalls of cotherapy. Individual interviews with a total of six cotherapists revealed three themes: (1) Cotherapy was perceived as an experiential learning journey that evolved from anxiety and excitement to empowerment and nurturing; (2) a collaborative master–apprentice relationship of openness, trust, and mutual respect was developed with both sides’ interactive effort, which included common commitment and concern for the client, the supervisor’s awareness and explicit address of the role hierarchy, principle setting prior to the cooperation, and honest pre- and-postsession sharing and discussion; (3) the dual-purpose supervisor–trainee cotherapy brought direct benefits for all involved parties and for others. The findings have useful implications for integrating treatment and training for optimal training/learning outcomes and for advancing knowledge transfer from senior to junior and from academia to the field, with reference to local cultural characteristics.     

Regulation strategies during COVID-19 quarantine: The mediating effect of worry on the links between coping strategies and anxiety

IntroductionThe COVID-19 outbreak forced Italian citizens into a generalized quarantine from March to May 2020. The quarantine is a successful measure to reduce the virus's spread through physical and social distancing, but it can also have negative psychological consequences on the population. People experience high levels of worry and anxiety and have to cope with the consequences of the health emergency. The aim of this study was to preliminarily assess the causal relations among coping, worry and state anxiety at the time of COVID-19 first wave, and the mediation role of worry between coping and state anxiety.MethodsDuring March 2020, 1273 Italian citizens completed an ad hoc online survey composed of sociodemographic and preoccupation-related questions, and standardized self-report questionnaire (Brief COPE, Penn State Worry Questionnaire and State-Trait Anxiety Inventory-State form). Three separate mediation models were performed.ResultsThe relationship between coping strategies (i.e.: problem-focused coping, emotion-focused coping and dysfunctional coping) and state anxiety resulted to be mediated by worry. Dysfunctional and problem-focused coping had a negative effect on anxiety scores and this effect was amplified by high levels of worry. Emotion-focused coping reduced state anxiety scores through its effect on reducing the levels of worry, which in turn was related to a reduction in anxiety.ConclusionThe present study offers first evidence for the mediation role of worry in the relation between coping and anxiety during quarantine caused by COVID-19 pandemic. It supports the clinical importance of investigating people's coping strategies along with the levels of (cognitive) worry and their long-term effects on the psychological well-being during the outbreak, in order to deliver adequate personalized interventions. Psychological support should enhance emotion-focused coping strategies that have a protective effect on both worry and anxiety.     

Determinants of sanitary measures and lockdown compliance among health professionals during the COVID-19 pandemic

IntroductionCOVID-19 pandemic forced several countries to establish sanitary and lockdown measures to prevent the spreading of the virus. Only necessary workers were allowed to work, including health workers in hospitals.ObjectivesThis study explores the association between some variables and sanitary measures compliance among health workers during a pandemic.MethodA total of 299 Health workers were recruited online using social networks. Participants completed questionnaires evaluating personality, coping, Anxiety and depression, psychological flexibility and sanitary measures compliance.ResultsCorrelations indicated most observant participants were more likely to present efficient coping and more based on problem solving. Also, Honesty-Humility as a personality trait was positively correlated to a better compliance. Regressions indicated the perceived utility of sanitary measures was the strongest predictor for compliance among health workers. Honesty-Humility and sanitary risks perception were predictors for compliance.ConclusionsThis study conducted among health workers points indicates variables associated with higher compliance. Our results suggest compliance and non-compliance as health behaviours or risk behaviours are linked to perceived threats. This perception is linked to health workers’ knowledges, their coping strategies, and personality.     

Intersections of personal vs. collective trauma during the COVID-19 pandemic: the hijacking of the human imagination

This paper explores how the deadly shadow of COVID-19 passing over the Earth constitutes a collective trauma that frequently opens up or ‘triggers’ un-remembered personal trauma, and it provides clinical examples of these intersections. The paper further explores how the human imagination, which we normally utilize to make meaning out of traumatic experience, can be hijacked by fear – leading to avoidance of suffering and to illusory formulations and alternative realities such as conspiracy theories. Alternatively, the imagination can be employed in more realistic and creative ways – leading through conscious suffering to healing and wholeness. Which path the imagination takes is shown to depend on the capacity of individuals to feel the full reality of the human condition in general and the exquisite vulnerability of our existence as fragile human beings at this moment in history. Ernest Becker’s analysis of our ‘denial of death’ and his urgency to embrace our common human vulnerability is explored in relation to Jung’s early tendency to deny the body. The author proposes that the more creative uses of the imagination, connected to a more humble and realistic apprehension of our common destiny, may be seen in the ‘Black Lives Matter’ movement that swept the world in the aftermath of the COVID-19 outbreak.     

Reflections on a wounded and bleeding temenos

COVID-19, Black Lives Matter, and financial and political turmoil have uprooted our sense of personal and collective safety and predictability. Analysts are faced with professional and personal challenges, as well as a charge to help make sense of this new normal. This reflective piece focuses on the author’s thoughts on a wounded and bleeding temenos. She grapples with the new reality of analysis carried out via technology (e.g. Zoom or telehealth). The article interweaves personal experiences with theoretical and professional reflections on two Jewish myths that relate to creating temenos or sacred space in the face of ancient disasters. Specifically, she discusses Choni HaMagel, a first-century BCE Jewish scholar and miracle-maker who prays for relief from a drought from inside a sacred circle. She also tells the tale of four Chassidic Rebbes who face crisis from a sacred space in the forest. The author frames this piece with two personal and numinous dreams dreamt during the pandemic; one offering scenes of destruction and one offering hope for a future transformation.     

George Floyd’s death and COVID-19: inflection points in the Anthropocene Era?

George Floyd’s death, the COVID-19 pandemic and climate change are on a continuum from the immediate shock of viewing a video-recorded murder, to millions dying worldwide from disease, to deaths related to climate change accumulating over a millennium. They participate in the powerful archetypes of death and inequality. ‘Increase’, Hexagram 42 in the I Ching, archetypically addresses inequalities at all levels – racial, economic, political and the profound imbalance between humans and the environment. Floyd’s death highlights the consequences of systemic racism and income inequalities. The pandemic as ‘nature’s revenge’ hits minority populations harder due to underlying health conditions resulting from poverty and greater exposure to the virus in the workplace. President Trump as Trickster showed Americans their shadow and his response to the pandemic amplified its severity. The pandemic has shocked our social, political and economic systems and paused our species rush into environmental disasters at many levels. The disruptions present opportunities for reflection, experimentation and developing new systems as old forms are challenged. The ecological dimensions of Jung’s concepts emphasize interconnectedness at all levels and the paradigm shift he called a ‘new age’ provides a framework for altering the course of the Anthropocene Era.