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Finding my way home: Ambiguous loss reconceptualized to bridge the conversion from in-person therapy to teletherapy during COVID-19

When Covid-19 arrived in March of 2020, I had a flashback from when I was ten years old. I was being transported from my homeland of Gimpo, South Korea to the foreign land of San Francisco, California. In the period of 15 hours-what felt like a blink of an eyeeverything changed. Similarly, COVID-19 abruptly transported me from the familiar model of face-to-face therapy to the foreign land of teletherapy. I recall the eeriness of that afternoon when an IT staff came into the intimate space of my office to install the infrastructure that enabled teletherapy. It felt like the calm before the storm. And whatever awaited, it was clear that there would be no dress rehearsal. Ready, set, go! Until now, the physical space of the psychotherapy room laid the foundation for the therapeutic relationship. It played an important role, a “holding environment” that invited patients to be present with themselves and be emotionally vulnerable with me. The room was transformed into a dress rehearsal for the real world. Here, patients tested their confidence to wear their wigs, and loosen the scarves around their necks to reveal the surgical scars marked on their bodies. Over the years, I had come to believe that technology inhibited the human expression of emotional vulnerability. And even more core to my identity was my belief that I had earned the invitation to witness my patients’ grief and transformation only through the meaningful relationships we had created in the therapy room. The instantaneous conversion of teletherapy meant there was no transition period or emotional space for me to explore its clinical implications. The technology quickly emerged as the “third person” in the room. The anticipation of a technical glitch, the attempt to decipher non-verbal cues, the distraction of my reflection staring back at me from the screen became all too consuming. This left me walking the tightrope of confusion and panic, and I lost my ability to focus my wholehearted attention on my