¿How are psychologists and doctors (gastroenterologists and psychiatrists) living clinical practice in the COVID era?
Interesting return of the students of a training in a Diploma in Psychogastroenterology that I direct regarding clinical care in the ERA COVID.
LIC. SILVIA L. BERNSTEIN
Given the “extra-ordinary” reality that we are going through, in the last class, I asked the students the triggering question “How are they experiencing daily clinical care today and how are they 'preserved / cared for' in their personal lives, due to to the overload of these times?
I found it very interesting to broadcast it, as it was verbalized by the professionals who attend the training, since mental health workers in general are very "crossed" by this critical and unprecedented situation, both in our personal lives, as to receive, contain, and accompany the intense demand and the prevailing and growing psychiatric epidemic throughout the world.
We also know that the basic and elemental condition to be able to do so is to try to stay in our "center" and psychophysical body as healthily as possible.
How they say they feel and take care of themselves:
• “Different emotions passed me by month by month, almost like a roller coaster of emotions ... We went from perceiving anguish for months to now perceiving sadness”
• “I feel annoyed, I notice more irritability in me, I attend twice as before, in addition to my traditional roles”
• “The confinement is tedious and physical contact strange”
• “I feel more tension, I take more massage, I do Tai Chi.”
• “Practicing mindfulness techniques, Hatha Yoga to reduce my cervical contractures”
• “Connecting as much as possible with the land, the plants, the garden.”
• “Doing a compassionate psychotherapy workshop.”
• “Appealing to laughter, friends, even through virtual encounters”
• “Lighting the fire in the fireplace, trying to cook in my spare time as it gives me pleasure”
• “By doing more physical activity, I go for a 40 km walk per day or by bike.”
• “I read and write”
• “Without watching television. I go to sleep early. In the mornings, I take an hour off to have a quiet breakfast before the phone explodes asking me to change schedules ”
• “I paint and do crafts”
• “I try not to take more patients than I know I can help. I refer to other colleagues ”
• “I nourish myself with good bonds, I do more physical activity than before the pandemic and I do it through the app ”
• “It's hard for me to make the time and do yoga online. I am not constant with the App ”.
• “I work more than before and I feel earache, which I decode as overload from what I hear. There are times when the song of the birds bothers me.
• “This work overload spread to other personal spaces. At the same time, I don't meet friends and I miss that space ”
• “We tell patients the importance of taking time for themselves; however in our personal lives it is difficult for us to put it into practice.”
• “Many patients are so messy that I feel like I don't have holidays, I don't have long weekends, I don't have weekends”
• “I feel" detonated "in a state of constant alarm.”
• “I have insomnia. Like many of my patients”
• “A life companion gastritis refloated me”
• “I had relatives with bilateral pneumonia who were afraid of dying, living the fears of my patients firsthand. I am re-signifying the depth of this tsunami.”
• “When I finish attending and to rest my mind, instead of watching the news before going to bed, I watch comedies, I eat small daily pleasures”
• "All people and patients feel fear: the death of close people increases it. and also in those we assist, if our patients die, the uneasiness and anguish grows. I have never had so many deaths in my healthcare life"
• “I continue with my personal therapy that I do not abandon and without which I could not go through these times”
• “At the same time, I feel blessed because I have a job and to be able to continue working in these times through telepsychology, which is also fortunately effective ”
How they experience the current clinic
• I receive an irruption of calls or messages to reschedule shifts.
• There is a lot of cardiological and oncological demand in addition to Psychogastroenterology.
• I perceive overflow and frustration in most of those who ask for assistance.
• What at first was fear of contagion, turned into a satiety and general bad mood.
• It is clearly perceived that it triggered unresolved traumatic experiences in many people, with covered abuses.
• There is a lot of demand for panic attacks and trauma and psychophysical fatigue that can no longer be used.
• Loneliness from not being able to touch patients is a central item. Being in isolation is one of the worst things that can happen to a human being. Without skin-to-skin contact, when seeing the doctor, "they only see two little eyes.
• I work many more hours than before and in front of the screen, with all its benefits and harms. If the internet goes down, it is an important stressor that blocks the possibility of doing the session and unfortunately it is a frequent variable.
• There is a large increase in consultations for anxiety disorders and digestive problems of all kinds. It is necessary to work with the body as psychotherapists with patients, since there is an intensification of the "alarm reflex" that is activated all the time.
• As there is a preponderance of telework, many cannot interrupt to do the sessions at the set times.
• I observe that the parents are desperate. Kids feel isolated with the Zoom and can't see their friends. They perceive that the school is not interested in whether or not they do their homework, and the parents resorted to doing their own therapy because they despair.
• We do not know what consequences it will have in the long term in education and in connection with the other, since there is no information about it.
• We were not prepared for this to happen to us. It is difficult for us to contain the children or the patients 100% and that is anguish. No one was prepared to have “school at home and office at home”.
• Many patients do not want to do online sessions because they lose privacy and stop coming or leave treatment.
• Everyone is sick of zooming.
• The adolescent fringe is one of the most hurt: from the illusion of quinceanera parties and graduate trips, only desire and frustration remain. Today you have to be isolated.
• In this second year of the pandemic, everything is enhanced, fatigue at the fore, and for many the dilemma of applying the vaccine or not given the ignorance of its effectiveness and secondary effects is a frequent issue.
• Now that we enter the patients' house, they show us their pets, their games and in the practice of the office, I try to regain playfulness, which is good for us. To all.
Personally, I hope that we can soon return to the face-to-face office format, with the exception of the virtual one if distances or psychopathological difficulties warrant it.
In the words of the South Korean philosopher Han “without the presence of the other, communication degenerates into an exchange of information: relationships are replaced by connections…, we have lost all senses; We are in a weakened phase of communication, which is what the international situation today allows and technologies facilitate.”
We will end this testimony of the time, with a certain conviction and hope: "You have to put a lot of hope and see a glass half full, trusting that this too will pass."
We are going through a "trauma disease" and as psychologists or doctors we need to nourish ourselves with rich supports for ourselves (good bonds, fun, distraction) to be able to assist and heal together with our patients, in the best possible way.
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