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In this paper, I will discuss the challenges in providing psychoanalytical treatment connected with pandemic. There are transformations in form and content of the sessions. First of all, it is moving from offline to online individual sessions and emerging of online therapeutic groups. Then it will be increasing the themes connected with COVID-19. In this paper, I write about my own clinical experiences during the time of pandemics, about widening psychoanalytic frames during this anxiety ridden time.
The COVID-19 pandemic in Kazakhstan is a part of the worldwide pandemic. The virus was confirmed to have reached Kazakhstan on 13 March 2020.
On 15 March, President of Kazakhstan declared a state of emergency from 16 March to 11 May 2020. On 30 March, many cities were under a lockdown.
The reality forced us to respect ourselves. We could no longer see our patients and supervisees in person. We were faced with a choice: either to cancel and stop sessions by the unknown end of quarantine, or to switch to online sessions.
I was adapted to running the sessions via Skype for the last two decades, even more in 2013, I wrote the paper Psychoanalysis Using Skype. (1) Since then, ‘a lot of water has flowed under the bridge'.
At the beginning of quarantine, I used Skype because it was my tool for almost two decades. Now I have to switch to Zoom because of technical troubles. Skype was good for individual sessions but not group work. Everybody from a therapeutic group could change mode on Skype, not due to their resistance, but because they were just beginners and they didn't know all the rules of using Skype. Secondly, if someone had a bad Internet connection, all the group suffered from the inconvenience. Zoom was better because only the organizer could manage it. If someone had bad Internet connection, only he himself felt that discomfort, but the group went on without interruption. Thirdly, possibility to set up a virtual background, let run the sessions from anywhere: a kitchen, a hall, a bedroom and any consulting room while my room was being renovated, or a hospital if you get sick.
After thinking and rethinking, I prepared and sent a letter to every patient, every member of the therapy and supervision groups offering them online work. Almost all the individual and group patients have agreed to use the Internet. Then they received a new instruction of working online from me. (See attachment 1)
Even P., being an ardent opponent of online sessions, who refused for many years to use the Internet during my or her trips, gladly agreed to move to online sessions. We still joke about that new “desire” of hers. The pandemic helped her to be more flexible and to be prepared to the unexpected changes... DOWNLOAD PDF: Psychoanalysis during Pandemic - Anna Kudiyarova (Almaty, Kazakhstan)
The COVID-19 pandemic presents a triple global public mental health challenge: (1) to prevent an associated increase in mental disorders and a reduction in mental wellbeing across populations; (2) to protect people with a mental disorder from COVID-19, and the associated consequences, given their increased vulnerability; and (3) to provide appropriate public mental health interventions to health professionals and carers. This challenge is compounded by the inadequate population coverage of evidence-based public mental health interventions before COVID-19, even in high-income countries. This article provides an overview of public mental health interventions that should be employed to address the impact of COVID-19 on mental health.
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