Patient name and other descriptors have been changed to protect confidentiality.
Sara is a 14 year old patient of mine. I am a clinical psychologist and have been treating her for about 15 months. Sara has struggled with trauma and associated psychiatric symptoms since the coronavirus ravaged her family.
This is the story of Sara’s treatment. What is so remarkable about her is her plight and her journey to recovery. And informative. And worthy to be shared.
Sara is a bright and social young teenager who navigated her day to day life. She had a happy and satisfied family with her parents and three siblings. She was a good student, had many friends and loved to ride horses. She was starting to show an interest in dating. And she loved going to high school and college football games.
Then the coronavirus pandemic struck. His world has been turned upside down. It was a traumatic time for her because her father was infected with COVID-19. He was extremely ill, requiring hospitalization and ventilation. After 12 grueling days in the hospital, Sara’s father passed away.
Sara was devastated by the death of her father. It didn’t make sense to her. She was riddled with powerful and endless questions: How could a virus kill her father when we live in the largest country on the planet? How could he not be saved? Did she do something wrong? How are we going to do it as a family? How can I help my mother?
Around the same time that losing her father, Sara’s school stopped in-person classes. He missed his friends and favorite teachers. Staying at home was a constant reminder of her father’s absence. But she was able to keep a watchful eye on her mother and siblings as they all struggled with their collective pain and grief.
Sara was clearly getting depressed. She was sad. She cried. She was tense. She worried constantly. She was afraid. She had trouble sleeping at night. His happy, joyous mind was now stifled. She wasn’t smiling or laughing. She was preoccupied with negative and morbid thoughts. She was cranky and catchy with her siblings. She has stopped talking to her friends on the phone or by text. She lost 15 pounds unintentionally.
Sara was brought to see me by her mother. Her mother herself was lost in sadness but could see that her daughter was struggling mightily. She feared that Sara would become more and more depressed and discouraged. She was afraid of being suicidal.
To her credit, Sara was eager for professional help. She and I connected immediately and our therapeutic alliance blossomed. We both knew she was deeply depressed by the sudden death of her father and the unintended daily consequences of this pandemic. I was worried about Sara, but I also knew that her excellent premorbid mental health meant that she had a very positive prognosis for recovery. But it would be a difficult road to travel.
I referred Sara to her pediatrician for antidepressant medication as her depression was so severe and it was affecting her sleep and appetite. She tolerated the medication well and it helped. She was grateful for it.
Psychotherapy with Sara progressed extremely well until she had to deal with yet another staggering trauma – her mother fell ill with COVID-19.
Sara decompensated with the news of her mother’s illness. Her depression flourished again when her mother was hospitalized due to the severity of her illness. Sara and her siblings went to live with her aunt, uncle and cousins while her mother was in the hospital. She thought it would be a short-term sleep arrangement until her mother came home.
But it was not.
Sara’s mother died of COVID-19 at the same hospital where her father died. Sara has been destroyed. She was consumed with fear. She felt lost and alone. She couldn’t stop crying.
Fortunately, Sara and her siblings were welcome to stay with her aunt and uncle. This stability was such a blessing to them. And Sara continued to see me in weekly therapy sessions. Her therapy had become a major anchor for her. She knew this was the place where all of her feelings and fears could be verbalized, understood and contained. By content, I mean she was able to sense her feelings and process them so that they didn’t overwhelm her in her daily life.
Sara was afraid of losing me too because of the coronavirus. It was a “transfer reaction” to the two deaths she had faced. His fears about me opened a new door to exploration. Even as a young teenager, she could understand that her dependence on me was due to the unexpected death of her parents. It also affirmed that we did indeed have a therapeutic alliance that allowed for honest and open communication about all of her feelings. It was psychotherapy at work.
Sara grapples with a mixture of intense feelings: sadness, fear, loneliness, guilt, a sense of responsibility and many more. All of this is water for the mill in its ongoing therapy.
Sara continues to see me every week. She’s weathered the storm of trauma and is recovering. She is still on medication, which helps her strengthen her defenses and shine her natural positivity and optimism. She feels in control of her life. She did not become a victim of her trauma but rather a proactive and healthy master of her emotional life.
The pandemic has created havoc and indescribable angst. He was underestimated by so many people. His victims have experienced traumas that will change the course of their lives. Ask Sara.
Sara’s recovery is a process, but it is palpable. We can feel it and we can see it. Psychotherapy and medication – alone or in combination – can make a demonstrable difference.
It is the resilience and recovery of patients like Sara that motivates me to do my job every day in the face of this dreadful pandemic. We all have to endure.
Alan D. Blotcky, PhD, is a clinical psychologist in private practice in Birmingham, Alabama.