Vulnerability in the Age of Online Therapy
by Becca Symmes, MA, LPC-C
June is here, heralding the summer pleasures of grilling, beach trips, and the long, languid days leading up to the summer solstice. And yet with all this summertime fun at our fingertips, this month marks two and a quarter years of living in a dramatically different world. As we all know by now, living through a global pandemic has caused enormous upheaval and uncertainty for many of us, in more ways than one. One of the most notable upheavals has been the advent of online visits with doctors and therapists on a scale nearly unheard of in years past. Now, in the age of COVID and lingering uncertainties of possible new variants, meeting with a therapist online is not only common, but offers benefits you might not otherwise receive from in-person therapy.
While online counseling existed prior to the pandemic, it was often extremely limited and not readily available to everyone who might need or want it. The widespread use of online counseling formats has increased access to mental health care for folks with limited mobility or other conditions that make it difficult for them to leave home. Access has also increased for those who live in remote areas and live far from the nearest therapist’s office; imagine having to drive an hour to and from your therapy appointment! For many of us who lead busy lives, this is a burdensome amount of time and could dissuade a person from attending therapy at all.
This increase in access to therapy has been immensely beneficial since greater numbers of people have been seeking therapy during the pandemic. Isolation and uncertainty have caused increased stress, and for those who live with their partners, being constantly cooped up together at home can cause increased relationship strain. According to eminent couples therapist and author of Mating in Captivity Esther Perel, every relationship has a certain balance of togetherness and separateness; this delicate balance can be thrown off-kilter by working from home or quarantining together for weeks on end. For many people, this change in their relationship dynamic has affected their sex lives… and more and more people are seeking sex therapy!
Sex is a topic that can feel awkward to address with a therapist, even if you aren’t experiencing issues with your sexuality. In American culture, sex is everywhere- billboards, perfume ads, television, movies, stand up comedy- and yet the topic in everyday conversation remains fairly taboo, particularly when meeting someone new. With this cultural taboo comes vulnerability; sexuality is constantly policed and judged by others, leading to anxiety about whether you can trust another person to hear your concerns about your sexuality and whether your situation is normal. First of all, in the words of sex educator and author of Come As You Are Emily Nagoski, everyone is normal! That being said, it is normal to feel at least a little anxiety about discussing such a sensitive topic with someone you have never met before. Vulnerability about our emotions is key to being able to work through them, and vulnerability is courageous.
Talking to a therapist online and with the added layer of a screen may help mitigate this anxiety related to discussing such a vulnerable topic. By feeling less physically exposed than one might feel in a therapist’s office, a person also might be better able to articulate difficult feelings related to sexuality.
In addition to feeling less physically exposed during online therapy, you may have more privacy in your home than is possible at an in-person therapy appointment. You may prefer to not be seen in a waiting room or entering a therapist’s office. Increased privacy can create a greater feeling of safety to discuss your sexuality or any other difficult emotions and situations. Since so much of sex therapy relies on becoming more present in your body, mitigating anxiety that might otherwise prevent being you from being present with your feelings is ideal. Anxiety is future focused, and can distract from what is actually happening in the moment. For a lot of people, being at home in a familiar environment- perhaps in comfy clothing and with a pet in your lap can make it much easier to focus on the present moment with your therapist.
Online therapy can also impact the way in which people implement the skills they learn in therapy. Let’s say you start learning mindfulness skills from your therapist in their beautiful office that feels like a yoga studio, but then go home to your apartment. Your home doesn’t have the same clean, calm feeling and aesthetics as the office, and you find yourself unable to use mindfulness skills the way you were in session. Why does something like this happen? Conditioning! Our brains have a tendency to learn by pairing different stimuli together when they happen at the same time; over time, your brain may pair the environment you are in (the pretty, clean therapist’s office) with the mindfulness that you learned there, making it more difficult to engage in that skill in a different environment. Now imagine you learn the same mindfulness skills from your therapist while in your apartment- you are already learning mindfulness in your everyday environment and thus may find it easier to implement mindfulness in your daily life. The same goes for couples therapy; it could be easy for some couples to practice communication skills in front of their therapist in the office, but then difficult to use them in the moment once they get home. If a couple learns communication skills via online therapy while already in their home, they may be more likely to use them in everyday life!
Overall, online therapy is a great option for those who value convenience and connecting with a therapist from the comfort of home. When starting online therapy, it’s best to create your own ideal environment for maintaining attention during the session and for being present; this can then translate into being more present with partners and for improving your relationship with yourself. For some people, online therapy may also be the first step to graduating to in-person services in the future. As we move forward in this unpredictable post-pandemic world, online counseling remains a great option for many to access mental health services in a format that wasn’t previously available. I hope that this increase in access continues to encourage people to engage in therapy in a way that works for them and get started on their healing journeys!