I stand in front of my bathroom mirror and try to control my breathing. It’s the morning after the election and I heard the results when I woke up about an hour ago. I had gotten up, showered, dressed, prepared breakfast and school lunch, ran to school and returned home, a bit of a wreck with a few minutes to spare.
I look at my watch. It’s 8:06 am and I have exactly nine minutes to cry intensely and then get myself ready for my first therapy session of the day. I count as I breathe and command the tears to go. I remember a professor in college telling us that the best thing you can do for a patient in need, before you say or do anything else, is to stay calm. “And how on earth am I supposed to do that?” I imagine myself yelling at him.
Of course I know the concept is important. I want to be that therapist from the movie, grounded, unclouded by emotional thinking, and creating a calm space of openness, curiosity, and equanimity.
But the truth is, I’m lost somewhere in the space between the idea of who I want to be and the unclear tangle of fear that resides in the pit of my stomach. Time is of the essence. With two minutes to go, I’m still breathing fast and definitely not calm. I splash water on my face and apply concealer under my eyes. Get out of your headI say to myself. Open your charts, open Zoom, refocus your attention outward, this day is not about you. To go.
Clients bring politics into the therapy room. This is what that means for the therapist
The day goes by quickly as I jump from session to session. I knew the topic of the election would come up in sessions, as often happens when major social or political events of magnitude and consequence strike. For many, the election results are the only topic we discuss. Emotions are generally loud: despair, anger, disappointment, fear, disgust, hopelessness. Histories of past trauma and abuse are being rekindled.
Living in the Boston area, many of the patients I work with share similar perspectives to mine. Hearing words that I agree with feels connecting. It brings a kind of unspoken synchrony to our experience, with patients speaking words that my mind has not yet been able to articulate. I need to understand the specific meaning and impact that the election results have had on patients, and how they play out in their lives. It’s easy for patients who generally have similar perspectives to empathize, but I don’t want to fall into the trap of overidentifying, assuming we think alike, and risk losing their personal experience. I have other patients who I know think differently than I do, and it is important to me to acknowledge and respect their perspectives as well.
I imagine what therapists across the country are hearing today and understand that I am only seeing part of the emotional spectrum. I imagine that other patients and therapists feel tremendously uplifted and invigorated, a reality that would be difficult for me to live with. In other sessions, the election is mentioned in passing or not discussed at all, and we continue with the theme we left off last week.
I’m not sure how to deal with themes of anxiety and existential dread. Some patients bring up the end of democracy as we know it, mass deportations and the threat of nuclear war. I probably would have questioned these scenarios a few years ago and urged us to question the factual basis of this fear. Today, these thoughts don’t seem so far-fetched. “What should I do now?” a patient asks between sobs. “What will happen to our world? Are we going to be okay?” It’s a strange feeling to admit that my answer is, “I don’t know.” I think especially about patients I see from vulnerable communities I work with: LGBTQ+ people, immigrants, undocumented migrants, members of minority groups, and others who have been targeted by hate speech. I think things probably won’t go well for a lot of us.
A thirty-year-old woman, who gives me permission to write about her, expresses her anger. She tells me how naive she was to what she now sees as people’s lack of humanity. Over the past year, she has suffered tremendous anxiety, depression and anger after being unfairly fired from a job where she had been sexually abused. “The world is so backwards. I don’t know anymore. I just don’t know what to say,” she tells me.
How your genetics could shape your politics
The outside world intertwines with personal lives; the outcome of an election is a fact, the way its reality weaves itself into life is a deeply individual experience. I confirm her experience and say something that it is difficult to trust the world. I’m talking about the need to stay grounded, to respect the emotional process, to refocus on what is meaningful, to return to the present, to return to what we can control. I’m dying to string some words together. I do therapy and feel like a cartoon character who has fallen from the tree as twinkling stars revolve around my head. I work in a daze and find myself fumbling with my words.
Later that day, I reflect on the wisdom patients have gleaned to cope with intense emotions: “I stopped watching the news.” “I have decided that I will be kind to others.” “Instead of remaining powerless, I’m going to focus on the things I can do.” “I spent some time outside and decompressed.” “I cleaned.” “I called my friends.” “I was holding my cat.” (What a great ideaI thought, reaching out to pull my own cat onto my lap.)
A supervisor once told me that when working with patients who are experiencing strong emotions and anxiety, we should first stop and take a breath. I lie down at night with my 8 year old and listen to him breathe as he falls asleep. I hold him tight and eventually my breathing slows down a bit. There are choppy waters ahead for all of us. Step by stepI think. For now, I’ll keep trying to breathe slowly. And I’m preparing for four years of telling my clients to do the same.
Sarah Darghouth is a clinical psychologist in the Department of Psychiatry at Massachusetts General Hospital/Harvard Medical School. She also has a private practice in Brookline.