My partner Tom thought that an interview with me would be a great idea, and I thought, “Why not?” Here it is! Thanks Tom.

Tom: So you’ve done teletherapy with couples a few times now.

Liz: 50 or 60.

Tom: How is it different?

Liz: Obviously we are not in the same room. We are seeing each other on a flat screen that sometimes has technical issues with audio and video quality. I think there is definitely a difference in the energy in the room.

Tom: What do you mean?

Liz: Well, when you see someone in person, that person is sitting across from you and the client can pick up on my energy and I can pick up on theirs. Like, my clients often remark that I seem calm and grounded. I can use my energy to support clients when they get upset. And I can see my client’s body language much better and pick up on nonverbal cues more easily, which is a big part of the work I do with couples.

What I’m realizing as I’m talking, though, is that although at first the energy can seem flatter and not as palpable, with a bit of time and doing deep work, it shifts to become more as if we are in the same room. I think it has to do with becoming comfortable with the online sessions, both for myself and my clients.

Tom: Tell me more.

Liz: My very first online session when I went 100% telehealth was just over a month ago. What a learning curve. The servers were overloaded. My audio wasn’t working. I didn’t realize there was a chat box feature so I was holding up little sticky notes to communicate.  Then my video seemed like it was reversing the note from my end, so I tried to write the message in reverse. I was quite flustered. The couple I was working with, who happened to be a newer couple for me, fortunately stayed with it and we ended up figuring it out. The next session went way better, and we did some deep good work. 

Tom: What do you mean by deep work?

Liz: This, for me, is the crux of couples work – supporting couples to tap into their deepest longings, along with their protective parts that might be interfering with giving and receiving love.

Tom: Mmm.

Liz: Yeah – you and I have talked about this a lot. How we come up with childhood strategies to deal with conflict in our families of origin, and how those strategies may not serve us well anymore. So getting insight on those strategies is super important – insight and compassion and a different relationship to them.

Tom: And it works online?

Liz: Yes. Absolutely. I can say that now because I’ve seen it happen. It’s not quick work, it’s deep work. It can stir things up for couples, and that can be hard, not being in the same room with them. I can’t hand them a tissue, for example. But the partners are there to tend to each other. And I can send messages of things to say to support the partner who’s upset via a chatbox, much as I do when I’m in person with them and pass them notes. Many people don’t really know how to be there for their partner when they’re upset.

But yes. I’ve found over the last month that this deep work is possible via teletherapy. This may be what deters some therapists from offering online sessions, especially for couples – and to be honest, I was deterred as well at first. But it is definitely possible, and really, I’m still me even if I’m on a computer or phone screen. And couples really do need help right now.

Tom: What’s going on now with couples, during this Covid19 crisis?

Liz: Lots of anxiety and stress. There’s been a lot of change for all couples – either they’re now working from home, with each other almost 24/7, or one or both have lost their job, or they’re on the frontlines, or their kids are home full-time, or they have a friend or relative who has Covid19 or who’s died from it alone in an isolated room. A lot to adjust to – a lot of transitions and loss and uncertainty and grief. And everyone’s affected by the overall unknowingness of the progression and devastation of the Covid19 situation. How long will this stay-at-home order last? When will the kids be able to go back to school? Will my loved ones be affected? Will I be affected? Will my business go under? Will our country recover? Smaller questions along with huge ones.

And being attuned to your partner, that’s harder when there’s a lot of anxiety hanging over your head and in your face.

Tom: Well, to me, irrespective of distress level it’s a time for couples to really realize they are an operating functional unit, each taking care of the other more directly, tightly, closely.

Liz: Definitely.

Tom: Which is a closer step towards hell if you hate your partner. But it seems to me that it can go from negative to positive, just because you’re actually partners, and you can see that, see the supporting actions of the other, feel your need and reliance on them, see the mutuality.

Liz: Right. Some of my couples have done better, and some have done a lot worse.

Tom: What’s going on with those getting worse?

Liz: They’re disconnected, they don’t know how to talk to each other, they trigger each other all the time.

Tom: Well, doesn’t the experience of shared purpose during this time break through some of that?

Liz: Yes, it can, but suppose you don’t have a way to talk about your anxiety or triggers because you never have talked about it, or if you do talk about it things just escalate so maybe you avoid bringing certain things up. And now the stressors on you, your family, your relationship, the world, have gone way up and you are getting triggered and escalated more. Not having an effective way to talk about issues because of triggers makes it very difficult and there can be chronic mismatch of intent and effect which can be really hard on a relationship.   

Tom: Right. And suppose you’re an introvert and it takes a high bar to make you say something.  Then you have to be pretty distressed to say anything, and then whatever you say comes from a high stress level, and it’s like all you say is a complaint and an attack. Like that?

Liz: That’s not being an introvert!  Do I have trouble saying things?

Tom: Obviously not.

Liz: Am I an introvert?

Tom: Yes.

Liz: It has nothing to do with being an introvert, Tom, it’s whether you’re comfortable with conflict. I’m an introvert and am very comfortable with bringing up conflictual things. I’ve worked with a number of couples that in the history of their relationship never talked about anything conflictual. It worked in their family of origin and it might work for a while in their relationship but it doesn’t work now. These are ways of coping that a child came up with, to avoid conflict, and it doesn’t work anymore because resentments grow and fester.

Tom: So a little bit of exercise in going through a pretend conflict might help?

Liz: No, you can’t just say Practice. You have to unpack it. Something is protecting you and you have to look at that protector part, give compassion to that protector, come into a different relationship with it, see what’s under it. It’s a lot of work, Tom. And avoiding conflict is only one strategy of protection. There are many others – and we all have them to some degree.

Tom: So git yerself to a couples counselor?

Liz: Mhm.  

Books can also be helpful – I especially love Wired for Love and Hold Me Tight. It can be difficult, though, for many couples to be able to look at their relationship objectively enough without getting triggered by what may be going on.

Tom: What do you say to couples who are having trouble?

Liz: I highly recommend couples counseling if you keep getting triggered by your partner or can’t seem to get out of a negative interactional pattern. And please don’t let doing online work deter you. I know from my own practice that good work can be done. And honestly, the sooner you start working on issues, the sooner you will get to a relationship that meets both your and your partner’s needs. It’s great work – difficult but great.

Honestly, I love doing couples work. So much healing happens in relationship.


Note: Most couples therapists have moved to telehealth with the recent Covid19 crisis. To find one near you, visit Psychology Today. Therapists must be licensed in the state where therapy occurs (that is, where you and your partner are at the time of therapy).