I stand in front of the bathroom mirror, trying to control my breathing. The morning after the election, I woke up about an hour early to find out the results. I got up, showered, got dressed, prepared breakfast and lunch, ran to school drop-off, and got home, a little disorganized even though I had only a few minutes to spare. I did.
I look down at the clock. It’s now 8:06, and after exactly 9 minutes of intense crying, I prepare myself for my first therapy session of the day. I count as I breathe, commanding the tears to disappear. I remember a professor in graduate school telling me that the best thing you can do for a patient who is suffering is to remain calm before saying or doing anything. “So how on earth am I supposed to do that now?” I imagine yelling at him.
Of course, I understand that the concept is important. I want to be the therapist in the movie. I want to create a quiet space where I feel grounded, unclouded by emotional thoughts, open, curious, and calm.
But the truth is, I’m torn somewhere between the idea of who I want to be and the confusion of unspoken pain in my midriff. Time is of the essence. There are only two minutes left, but I’m still breathing quickly and it’s not like I’m calming down by any means. Splash some water on your face and apply concealer under your eyes. Get out of my headI tell myself. Open your chart, open your Zoom, and refocus outward. This day is not about you. go.
Jumping from session to session makes the day go by quickly. As is often the case when major social and political events occur, I knew that the topic of elections would come up in the session. For many people, election results are paramount and the only topic we discuss. Emotions are generally magnified: despair, anger, disappointment, fear, disgust, hopelessness. History of past trauma and abuse resurfaces.
I live in the Boston area, so many of my patients have a similar perspective to mine. When I hear words that I agree with, I feel like my heart is connected. It brings a kind of implicit synchronicity to our experience, and the patient articulates words that my mind hasn’t had time to verbalize yet. We need to understand the special meaning and impact of election results for patients and how it impacts their lives. It’s easy to empathize with patients who generally have similar points of view, but I often fall into the trap of over-identifying, assuming we think the same way, and in the process end up hurting my patients’ personal lives. I don’t want to risk losing that great experience. Other patients I know feel differently than I do, so it’s important to me to acknowledge and respect their perspective as well.
When I imagine what therapists across the country are hearing today, I realize that I only see a small portion of the emotional spectrum. I’m sure other patients and therapists feel very cheerful and energized, but this is a reality that is difficult for me to accept. Other sessions will touch on the election, or not at all, picking up on topics left unattended last week.
I don’t know how to deal with the subject of anxiety and existential fear. Some patients bring up the end of democracy as we know it, the threat of mass deportations and nuclear war. A few years ago, I would probably have questioned these scenarios and urged me to question the factual basis of this fear. Today, these ideas don’t seem so far-fetched. “What should I do now?” the patient asks between sobs. “What will happen to our world? Will we be okay?” It feels weird to admit your answer is “I don’t know.” I’m especially thinking about the patients I see in the vulnerable communities I work with: LGBTQ+ people, immigrants, undocumented immigrants, members of minority groups, and people who are attacked by hate speech. I think most of us probably won’t be okay.
A 30-year-old woman who received permission to write expresses her anger. She tells me how naive she was about what she now considers people’s lack of humanity. For the past year, she has suffered from extreme anxiety, depression, and anger over being unfairly fired from the job where she was sexually assaulted. “The world is so backwards. I’m in trouble. I just don’t know what to say,” she told me.
The outside world is woven into the individual’s life. The outcome of an election is a fact, but how that reality is woven into one’s life is a deeply personal experience. I justified her experience and said something to the effect that it’s hard to trust the world. I am talking about the need to stay grounded, honoring emotional processes, refocusing on what is meaningful, coming back to the present, coming back to what we can control. I’ll talk. I’m amazed at how many words I can string together. I go into therapy feeling like a cartoon character falling out of a tree with stars twinkling around my head. As I work absentmindedly, I find myself fumbling with my words.
Later that day, I reflected on the wisdom my patients summoned to cope with intense emotions. “I stopped watching the news.” “I decided to be kind to others.” “I wanted to focus on what I could do instead of remaining helpless.” “I spent some time outside and calmed down.” “I cleaned.” “I called a friend.” “I held the cat.” (what a great ideaI thought as I reached out to pull my cat into my lap. )
One of my supervisors told me that when working with patients who are experiencing strong emotions or confusion, I must first stop and breathe. I lie with my 8-year-old son at night and listen to his breathing as he falls asleep. I held him close and my breathing finally slowed down a little. We all have a tumultuous future ahead of us. one step at a timeI think. For now, I will continue to breathe slowly. And I’m preparing for four years of telling my clients to do the same.
Sarah Dargose is a clinical psychologist in the Department of Psychiatry at Massachusetts General Hospital/Harvard Medical School. She also has a private practice in Brookline.
