Regina Tricamo has been a therapist for 15 years, and nothing has permeated her clients’ worries quite like COVID-19. The closest thing, she says, was the whirlwind of grief she helped people sift through after the 2016 election (she specializes in women's health and works out of an ob-gyn clinic), but even that didn't stir up the same level of fear as this invisible, unknowable enemy.
Plus, she's just as freaked out as most of the people she's counseling. We asked her how she's helping people weather a crisis that's hitting her just as hard as it's hitting them, and she came back with wise words, a snack order, and tips for putting together one hell of a home office.
"I think it's kind of neat to be recorded within 48 hours of the death of Linda Tripp, who famously did not ask Monica Lewinsky if it was okay to record her. [Editor's note: In keeping with best practices, I did, in fact, ask Tricamo if it was OK to record our call.]
"My particular work group hadn’t ever done video visits, so we're just doing phone. We felt it was too hard to learn yet another new thing. I’ve always done some therapy by phone, but to do all of it is different. And some of these are clients that I’ve been working with for a long time, so we already have trust established and I know them pretty well. But some are new. [I’ve had] quite a few [first appointments via phone] now.
"It just makes you remember, again, how much we use the body and people’s facial reactions and all that stuff to help figure out what’s going on for them and where we can help move it. So it’s been challenging. This is gonna sound so silly, but it’s kind of necessary: we’re all doing more verbal affirmations. Like, lots of, 'Mhm. Mhm. Yes. Uh huh.' The cartoon guy in the chair with his back to the patient on the couch: 'Mmmm. Tell me more.'
"I'm set up in my bedroom, because it's a private corner. I have to have a door that closes, and I have to know that no family member will walk in. HIPA compliance is really key, as well as, of course, just doing a good job. I can’t be interrupted. I arranged it so I can look out a window, which has been super helpful ... and my jewelry is hanging in front of me. My necklaces. It’s just something that gives me pleasure. All my necklaces are from local artists, and I feel good about that little piece of my buying history, so each of those has a good feeling connected to it.
"I recently moved a more comfortable chair in, which is an about-100-year-old chair from the U.S. Senate that my father-in-law found in a dumpster behind the senate building. It's not a super fancy new office chair, ergonomic and all that, but it’s padded and it’s leather and it’s got these cool gold wheels. I think it actually adds a little something to my practice.
"[If someone is] talking about their anxiety, I can feel them—they're definitely reacting, right? What I’m trying to do more and more is to just ask them to stop for a second, feel it, and notice where in their body it is. That’s been really helpful, because so often, we’re not paying attention to where this stuff is in our bodies, right? A lot of us have gotten messages about disconnecting from our bodies, about not paying attention, about just pushing through. And if I can ask somebody to stop and pay attention, they’ll see where it is in a way that I might have pointed out in an in-person session together. So it’s been fun to try that. I’m having to try to think a little bit differently about my job. It's sort of confidence building, I guess, that all things don’t have to perfect in order for me to do my job well.
"One thing that's interesting is that some people who are generally very anxious all the time are kind of doing a little better. I've read this from other therapists as well. There’s something about the outside world matching with their internal reality that is kinda comfortable. It’s like, ‘Hell yeah I’m anxious, and so are all of y’all!'
"Part of the real challenge of this work right now is that the things my clients are anxious about are the same things I'm anxious about. What I’ve had to do is really work on how to care for myself between clients so that I can stay present for them. It has meant that I am—how do I phrase this in a way that my employer doesn’t, you know, panic? I am not a hundred percent productive. I am taking a little break in between most of my client sessions if I have a moment. I’ll go step out on the deck so I can feel the fresh air or smell the spring scents or feel the sun. I will occasionally sit in my senate chair and take a couple of deep breaths and just sort of notice how my body is doing. And sometimes, you know, I’ll go down and get a bowl of Doritos. I swear to god, that was my first COVID order. ‘There will be Doritos.’ Cool Ranch. I'm trying to give myself the grace that I ask my clients to give themselves.
"I do want to be clear that I’m not sleeping very well. I’m not always coping well. I think it’s really important that therapists don’t set themselves up as, like, ‘I’ve got this shit all together, look at me!’ But what we know about trauma and high stress is that our responses tend to be the responses that are our patterns since our childhood, that came out of our families of origin. Mine became very, very clear at the beginning. I need to be able to keep an eye on how everybody is doing. And that works super well in you’re in session with a client, and really not so well when what you’re doing is obsessively reading about Italy or Spain or New York City.
"It also came up for me that I had this intense, visceral need to have my children where I could see them. My children, who are functioning adults with lives not near me. I tried to talk [my daughter]—not really, but I said as, you know, a joke—'Why don’t you just hop on a plane?' when her work got furloughed. 'Why don’t you just hop on a plane and shelter in here?' And she’s like, ‘Uh, ma. We’re not supposed to travel, and I have a boyfriend who I love, and if I came there, I would have to quarantine for 14 days without seeing grandma.’ And I was like, okay, you may have a point.
"So my first reactions were things that weren’t actually that helpful. And I had to figure out, how do I honor that need to know how people are doing without it becoming detrimental and unhelpful? Well, the best way by far: we have a weekly standing family game night. We play an online game where we’re all playing in real time against each other, and then we do a Zoom call on the side so we can catch up and trash talk and kibitz and all that. I can’t even explain to you how much, I just feel it in my heart, it is so—just—I don’t know. Calming? And delightful. To get to see that my kids are okay.
"I feel like I can still do my job. From what I’m hearing from my therapist friends, they feel like they can too. Part of our training is to take care of ourselves. Part of our training is our self-care. We’re in kind of a good place in terms of referrals and all that piece. It is just kind of a funny thing to have all of us worried about the same thing right now."