Containing the Anxieties of Children, Parents and Families from a Distance During the Coronavirus Pandemic
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ORIGINAL PAPER
Containing the Anxieties of Children, Parents and Families from a Distance During the Coronavirus Pandemic Jordan Bate1 · Norka Malberg2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The coronavirus pandemic and the move to teletherapy has created uncertainty among both clinicians and patients. As therapists who work with children, we have heard from parents who are desperate for support and advice about how to respond to their children’s behavioral changes, as well as those who feel too overwhelmed to continue their children’s sessions at the moment and want to take a break from treatment. We have had to rethink the frame in concrete ways, reimagine how to play, and renegotiate parameters around confidentiality. At a time when fear and uncertainty make mentalizing difficult, the hallmarks of a mentalizing approach—curiosity and flexibility—are most critical. This paper will describe how the Mentalization-Based Treatment for Children (MBT-C) model offers a framework for an integrative approach that can inform treatment via teletherapy, so that clinicians can continue supporting young people and their families through this period. We will begin by describing how the mentalizing stance, particularly an awareness of our own mentalizing capacities in the moment, has become more important than ever. Ways in which clinicians maintain their mentalizing in the face of the mentalizing breakdowns will be also discussed. Finally, we illustrate with clinical vignettes how the developmental levels of mentalizing—attention control, emotion regulation, and explicit mentalizing—can inform the structure, techniques and interventions in teletherapy with children and parents. Keywords Mentalization · Child psychotherapy · Attachment theory · Teletherapy
Introduction The coronavirus pandemic has elevated fears, anxieties and stress, and the precautions have isolated individuals and families. Measures have included closing schools and moving lessons online, resulting in millions of children being confined to their homes. This situation has created an enormous burden on parents to provide care, security and safety, while facilitating home schooling and balancing work and fears of their own. Hesse and Main (1999) remind us that “Whether or not attachment behavior is displayed at a given time, the young attached individual must at some level continually attend to the safety versus threat implicit in current conditions, while simultaneously monitoring the location * Jordan Bate [email protected] 1
Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Bronx, NY 10461, USA
Yale School of Medicine, Yale Child Study Center, 230 S Frontage Road, New Haven, CT 06519, USA
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and accessibility of those attachment figures upon whom its survival depends.” (p. 494). While children monitor the location and state of mind of their caregivers, they and their parents also monitor the location and accessibility of their therapists. A 2010 report from the National
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