THE COVID MONTHS |THREE COUNSELLORS WORKING WITH NHS STAFF LOOK BACK ON THE LAST TWELVE MONTHS
SARAH WOODROFF
As we pass the anniversary marking a year since the first lockdown, I have found myself reflecting and reminiscing over the events of the last 12 months. Today, I watched Jason Manford do a routine about feeling nostalgic over lockdown one: how it seemed like a happier, more relaxed time. It made me laugh because I resonated with it so much; I look back and remember the walks in the sun, baking with my children and enjoying having more family time. It is easy to misremember and see it as a long holiday. Then I remember how I felt when I was first asked to work on the NHS scheme that the Northern Guild was running, and I remember the fear that was in the nation, in the world. I was expecting to hear horror stories from doctors, nurses and consultants who were working on the frontline: on covid wards, A&E and intensive care units. I anticipated hearing about ghastly death scenes, about grief and about discomfort from working in sweltering heat whilst wearing PPE. I hit the textbooks and read up on trauma models, revised grounding techniques and signs of being outside the Window of Tolerance; I was expecting to meet people in the depths of trauma. A year later I have found that, so far, these are not the stories that have been brought into our sessions. Instead, I have heard about the human struggles that lockdown and the pandemic have caused throughout society: relationship worries, feeling (and being) stuck, having choice and freedom removed, of being overwhelmed by work and life pressures.
The stories I heard from NHS workers in the first lockdown centred around fear. Fear of catching the virus. Instead of hearing about how uncomfortable the PPE was, I listened to fear that it wasn’t effective enough. There was fear about carrying the virus back into homes and passing it on to loved ones. There was fear over what would happen if they got sick; who would look after their children? How would they cope? The bubble system wasn’t in place then and the fear was exacerbated because they had first-hand experience of how sick this virus made people. Then there were stories of anger. Anger towards the government for not providing enough PPE, anger about the narrative in the media, “we did not sign up to be heroes” is a phrase that I heard over and over again, it was strong and heartfelt. Then there were feelings of uncertainty; not knowing where they were going to be deployed to, and unease about working outside their area of expertise. “Be Perfect” drivers were triggering anxiety as they were being placed onto new wards and required to be an effective part of the team without having up to date knowledge or skills in this area. “Be Strong”, “Don’t Feel” and “Don’t Be Important” are common drivers and injunctions amongst NHS workers and made asking colleagues for help difficult and anxiety worse.
As we moved out of the first lockdown and restrictions began to ease, I noticed that feelings coming into sessions were of overwhelm and exhaustion; people were burned out. Our work centred around permission for self-care, the message being that it is essential and not a luxury. We talked about ways of implementing it into already busy lives. Drivers of “Be Strong” and “Work Hard” and injunctions of “Don’t Feel” were present in the majority of sessions and knowing how much to challenge or raise awareness of them felt like tightrope walking; how much do I focus on what may make them really good at their job but may also be contributing to exhaustion and anxiety? These themes remained present as we entered the second lockdown and now pressures in relationships and families emerged too. I heard about the pressure that came from caring for patients and colleagues at work, and then going home to the demands of family life and relationships; there was little room for their own Inner Child’s needs and expression. It reminded me about a passage in Woollams and Brown’s textbook that talks about when a mother is looking after her new baby,
“For the best parenting to occur, a parent should give priority to taking good care of herself…when a mother’s Child is taken care of, she is in a much better position to care for her infant” (Woollams and Brown, 1979, p.100-101).
When our NHS workers are working in a pandemic, who is looking after their Inner Child? Maybe their spouse, partner, friend, maybe their therapist. Work has been focused on asking for support and on the Drama Triangle. Gently bringing into awareness the Rescuer position and challenging the Frame of Reference that says it is their job to look after everyone at work and at home: perhaps it is ok to ask for help, perhaps other people can do more than you think, perhaps it is ok to ask someone to put the dinner on when you have worked four 13 hour shifts in a row.
Lockdown 3 seemed to hit people hard. The expectation that things would get better in 2021, the hope of the vaccine, and then being put into the third lockdown during the coldest, darkest and bleakest months has been tough for people. Our contracts have centred around support through the next few weeks, “I can see the finish line in the distance, just help me get through this last bit” is a phrase I have heard, and it conjures up images of runners staggering, swaying and crawling towards the finish line: they need an arm to support them in the last few steps. I remember in our first year of training our tutor told us about the transformative experience a person can have from being truly heard and seen. She said that so many of us have never experienced this before coming to therapy. This stuck with me and it is something I remind myself of when my self-doubt about my abilities as a therapist rise, when I can’t remember the theory or cringe when remembering a failed intervention. This is what I have focused on in these sessions. Six sessions of forty minutes, where all emotions are permitted and I am fully present and actively listening, and I have watched people grow and feel much better. I have seen people achieve their contract after one session. To tell their story, and be heard, is healing.
Now the country and the world are starting to cautiously look, with a glimmer of hope, to returning to a “normal life”. With a timetable in place and a successful vaccination programme running it seems that it is a real possibility. This is bringing different reactions into the sessions. There is anxiety about what the future will be, the anticipation of feeling lonely amongst others, and of not wanting to return to a previous way of life. Now our work is about choice and permission for change.
As I look ahead to the next year, I wonder what the future will bring for the people working in the NHS. What will be brought into our sessions? I still expect trauma to appear. I think that it will come as the storm passes and people have a chance to breathe and reflect. I suspect that it will come as memories of the traumas they have witnessed and lived through start to resurface. I am expecting it and preparing for it; those trauma textbooks remain close to hand! I also feel hopeful that as a nation we have come to appreciate their work and how much we need them. The clap for the NHS was controversial as some people felt that it detracted attention from the lack of funding that they had, but a positive side was that it allowed us to show our appreciation. My hope is that this will continue and that the people working to help us heal when we are sick will not be forgotten and instead will continue to receive our thanks, appreciation and care.
CLAIRE BARRON
It has been a real honour to be working with NHS staff and carers. I have felt in awe of their dedication and selflessness during the pandemic and grateful for all the knowledge that I have gained.
Over the last 12 months we have truly learned about the healers and carers in our society and just how hard they have worked to try and keep our most vulnerable safe, well and comfortable. Not to mention the huge personal impact for them when their knowledge and skills have not been enough to save lives.
I was delighted to be asked to be part of the initiative to offer a free counselling service to those working in the NHS and caring professions. I was a little nervous about what to expect and how I would adapt to the structure of the service - six sessions of forty minutes each.
The clients I spoke to presented with a range of difficulties especially stress, anxiety low mood and depression. People were surprised and relieved at the speed of access to counselling. With our service it generally takes about two days from someone reaching out and making first contact to them being able to sit with a counsellor. Immediate responsiveness is one of the underlying principles of the service and something that far exceeded people’s expectations. It always takes them by surprise.
For me adjusting to slightly shorter sessions of forty minutes was initially a challenge. Holding the boundary of a sessions timing can be a challenge at any time, but I think over the years I have adapted to fifty minutes, and as well as the ever present clock, mentally and physically I know how long fifty minutes is, so I had to really focus on time keeping! I had quite an internal debate about these clients deserving more time not less, which was interesting and challenging for me. But what I did find was that you can really do very good work in forty minutes and in into six sessions. It has given me a much greater appreciation of short- term work and its benefits and effectiveness.
This important service enables me to see more clients than usual and, although hard to put into words, it has freed up my thinking. Focussing on what you can do in six shorter sessions is actually quite empowering. It has taken me back to basics but at a whole new level, deepening my understanding of the therapeutic relationship and my ability to work within it. It is crucial.
My feeling is that we are only at the start of the support that our NHS and caring community will need, and that right now they are very much ‘in it’ and getting things done, putting others first, as ever. If, or optimistically when, we move beyond our current crisis I feel that as counsellors and psychotherapists we will play an important role in supporting these incredible human beings who have put us first at huge personal cost.
I want to appreciate everyone at Northern Guild who has enabled me to take part in this project and especially my supervisor. I look forward to carrying on as one of the team of counsellors working to do what I can to help create a private space where people can reflect, unwind and recharge.
ROBIN COOK
I feel incredibly privileged to have worked on the Northern Guild NHS Counselling Service during the last twelve months. As the first national lockdown began to unfold, I had a real sense that the skills and learning I'd taken from my training could be of use in supporting people who were struggling during the pandemic. Yet, the isolation of lockdown lead to a feeling of helplessness, a sense that it was going to be hard to be useful in an environment where there were no people.
When the opportunity to work on the NHS service arose I felt really lucky. I could make a contribution by offering our NHS workers free access to counselling sessions at a time when their work was at it's most stressful and the nation at its most uncertain. I have been really impacted by the work. It has reaffirmed my belief that every individual should have access to counselling that they can afford, when they need it. I've come to understand that there are a lot of people who have always thought about trying counselling but have felt put off, be it by fees, confusion about what they are signing up for or fear of getting something wrong. Six free sessions has been inviting to a lot of people who may otherwise have not started counselling. I feel really thankful to have been part of this placement and to have met all the people I have worked with.